Professor Anthony Maeder, co-Director Flinders Digital Health Research Centre

The effect of the COVID-19 pandemic in catalysing various digital health initiatives at population scale has been widely reported, including delivery of various health services remotely such as e-prescribing, online triage, personal monitoring, and telehealth. The tremendous popularity achieved for GP telehealth consultations enabled by the provision of special MBS items is perhaps the most prominent example (1) and has been widely accepted by consumers.

Coincidentally this heightened focus on digital health and remote service provision in our current everyday life experiences comes at a time when health systems are pivoting anyway, on various axes. Health reform agendas based on quality and safety improvements, and on envisioning new models of care reliant on team endeavours and patient self-responsibilities, are converging to an acceptance of “virtual care”. (2) This concept embraces all the established telehealth modalities, but stretches broader to cover the distribution of care services across multiple sources and channels of delivery, and multiple physical and human settings for the nature of the care.

Apart from the many whole-of-population COVID-19 digital health reliant interventions, we might ask whether any new special virtual care health services are being made available for older Australians, either in independent living or aged care situations. We recently investigated this question (in a cooperative project between RePaDD and FDHRC) by a cross-sectional analysis of scientific literature and media reports on remote interaction healthcare interventions supported by digital technology, in the care of older people in Australia. (3)

Our findings from this study identified four major categories of digital technology supported innovations which were reported as being used actively in the aged care sector for addressing remote delivery needs due to COVID-19 impacts on health systems operations:

• remote consultations for healthcare services – generally via conventional telehealth;
• remote monitoring of the health status of people – in home surveillance and care assistance;
• support for independent living of elderly – alarm response, respiratory care, daily living;
• communications between older people and carers – care management, social connections.

Within the study we also discerned four distinct delivery settings for these virtual care categories:

• self care, people managing their own health care services needs;
• home care, service provider managed health care in people’s homes;
• rural care, service provider managed health care in non-urban locations;
• residential care, professionally managed health care in certified facilities.

These findings showed us that technology support for aged care and independent living interventions has been deployed successfully across a wide range of service organisations using products from numerous technology vendors. Due to the pandemic, this type of remote interactive healthcare support was an essential development and demonstrated that diverse combinations of digital technologies can be developed rapidly and effectively to support the many needs of older people to stay healthy and live independent. While there are system complexities to be addressed in any new digital technology deployment, the technical aspects are seldom the major barrier to its realisation.

This study also suggested to us that while significant benefits could arise from increased application of digital technologies in health and aged care, there has been insufficient attention paid to addressing or strengthening the enabling factors. The extent of the achievable benefits will depend very much on building confidence in the use of telehealth technologies through collaborations, developing clinical frameworks, skills and digital literacies, providing appropriate physical, information and communications infrastructure and supportive funding models for services that use digital technologies to assist maintenance of the health and well-being of older people.

References

1. Snoswell, C.L., Caffery, L.J., Hobson, G., Taylor, M.L., Haydon, H.M., Thomas, E., Smith, A.C. Telehealth and coronavirus: Medicare Benefits Schedule (MBS) activity in Australia. Centre for Online Health, The University of Queensland. May 19 2020. Available from:https://coh.centre.uq.edu.au/telehealth-and-coronavirus-medicare-benefits-schedule-mbs-activity-australia.

2. Murphy B, Gebreyes K, Wells L, Hambleton S, Simpson M, O’Kane, Shaw T. Reimaging Healthcare in Australia; The role of digital in future health delivery. September 2020. Available from: https://www.digitalhealthcrc.com/wp-content/uploads/2020/09/DHCRC-Reimagined-Healthcare-Discussion-Paper-FINAL.pdf

3. Alan Taylor, Jennifer Tieman and Anthony Maeder, “Digital Innovations for Aged Care: Impacts in the COVID-19 Pandemic”, in: Proceedings of Australasian Institute for Digital Health 2020 Summit, IOS Press (to appear).