Lessons from pandemic telehealth, for aged and others

The COVID-19 pandemic has prompted rapid and widespread increase in use of telehealth and associated ehealth services, in Australia and internationally.

But experts warn there is some danger that the ad hoc adoption of these technology-based innovations may result in them being short-lived and later discarded, due to their narrow impact and lack of integration with existing ‘infostructure’.

“Changes in care delivery processes and mechanisms have been very widespread, from primary to acute care,” says Australasian Telehealth Society National President Ms Jackie Plunkett.

“We need to learn from this experience, and ensure we have enough flexibility and resilience in our health systems to enable changes like this to happen safely and sustainably, into the future,”
she says.

This unprecedented growth has transformed the way in which may healthcare services are delivered, almost overnight, with immediate positive effects on throughput and cost effectiveness.

The national Telehealth Society has initiated a major national survey to capture some of this knowledge on the adoption of telehealth services in response to the pandemic – including digital health innovations in the aged care sector such as teleconsultations.

While the multiplicity of new services is a bonanza for the digital health market, it brings with it an unmet need for considering how to join up and sustain these many independent initiatives.

Professor Anthony Maeder, co-Director of the Flinders University Digital Health Research Centre, says: “It is as important to follow up with critique and evaluation of new telehealth and ehealth services, as it is to develop the new services in the first place.”

The Flinders research group has recently developed a universal framework for this purpose.

Professor Anthony Maeder and Professor Trish Williams, who head up the Digital Health Research Centre at Flinders University.

“It is essential that we adopt an inclusive 360-degree process,” says Professor Maeder, “with input on clinical processes, health system components, broader stakeholder impacts, and the technology business environment.”

The framework has already been applied to analyse examples of new COVID-19 telehealth consultation services, and COVID-19 mobile phone tracking apps.

“Only with a systematic and comprehensive structured approach such as we have suggested, can the impact and potential of these new digital technology enabled health services be fully evaluated,” said Professor Maeder.

Professor Maeder and Gary Morgan, from the College of Nursing and Health Sciences at Flinders University, have recently published a report, ‘Smart Ageing: Digital Solutions for Future Care’ in Digital Personalized Health and Medicine DOI: 10.3233/SHT1200246

It proposes a framework for discourse on digital solutions to support consumers and carers in delivery of health care and services for aged persons, based on a major needs analysis conducted across 56 diverse business entities in Australia.

The resulting framework was based on two major identified domains: “Ageing in Place” for independent living situations, and “Ageing with Care” for managed aged care facilities.

The World Economic Forum has estimated that by 2050 more than 20% of world population will be aged 60 years and older. In Australia (typical of developed countries) the proportion is even higher. It has been estimated that by 2046, 22% of the population will be aged 65 years and older, and that average life expectancy will be 85 years with 19% of older people (i.e. over 4% of population) being aged 85 years or older.

“Today’s older citizens wish to remain living in their own homes and to pursue an active lifestyle as long as possible, with appropriate support where necessary,” the research says. “This transformation will undoubtedly incorporate digital technologies including health care support.”

The Australasian Telehealth Society is committed to providing a united ‘voice’ for telehealth advancement covering a broad range of domains including the health sector, academic institutions, government and industry partners.

“Moving the boundaries of telehealth to bring health care practices into the 21st Century is the opportunity before us,” says Ms Plunkett.

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College of Nursing and Health Sciences