Message from the CEO
Stay well, everyone.
Our farming readers know that rural Australians don’t just think about the weather for agricultural purposes; they also need to factor in the rain when they need a stable internet connection. We at the SARRAH National Office have had direct experience of this as we connect with our remote workers in rural locations across three states. The quality of our video meetings is definitely affected by the weather.
Our members are telling us that they have pivoted to telehealth service delivery with varying levels of success. This is a game-changer for some and will theoretically increase access to and choice of service providers in areas where providers are thin on the ground in rural areas. For other providers, the quality of the internet connection has been a major barrier to delivering services via this modality.
So how have health consumers managed the switch to telehealth? Accessing health services via telehealth assumes that the person accessing the service has the hardware, infrastructure and capacity to do so. This also assumes that the person has the space in their home for privacy to engage in telehealth. We know that many rural and remote Australians continue to struggle with access to reliable internet connections. We know that many of our most vulnerable households don’t have the means to engage in telehealth; for that you need access to a connected telephone/internet and devices to support telehealth. So does telehealth highlight the underlying vulnerabilities for socioeconomically disadvantaged groups further?
Looking at the MBS data for frequently billed items for allied health, it appears this may be the case. When we look at the break down of how services are accessed we can see that the overwhelming majority (94.52% to be exact) of allied health services for people with chronic health conditions during the month of April were provided face to face. Of the 24,660 telehealth sessions delivered by AHPs to people with chronic disease over the same period, 68% were via the telephone. Does this suggest a lack of basic infrastructure to support video consultations? The federal government recommends that telehealth should be provided via a videoconference platform unless this is not possible. Why was this not possible for 68% of the sessions delivered to people with chronic disease?
This picture will continue to unfold as we see data released from private health funds and the NDIS as we know that there are many other areas of telehealth that have been core business for allied health during the COVID-19 pandemic.
The introduction of additional MBS items in late March demonstrated a commitment from the Federal government to ensure all Australian’s had the opportunity to maintain access to primary health services. Allied health professionals are vital in the management of chronic health conditions. Allied health professionals work to improve health literacy and keep people well and out of hospital. The MBS data demonstrates a disturbing trend in access to services during the COVID-19 pandemic. In April 2020 we saw a 31% drop in the number of MBS claims made for the provision of allied health services in the management of chronic disease compared to the same period last year. Where are these patients? How are their conditions being managed at this challenging and isolating time?
SARRAH has been working with our colleagues of the Australian Allied Health Leadership Forum (AAHLF) to raise awareness with the Commonwealth of the need to prepare for a surge in demand for rehabilitation and post-acute care services for both COVID and non-COVID patients. Currently this area is not well understood by government, particularly those activities that occur in primary health settings, and funding for rehabilitation that happens outside the hospital setting is largely left to private health insurers and third-party payers. AAHLF is calling for the government to take action to manage a surge in demand for services to the same level as the acute and mental health response has been. If left unmanaged we may anticipate that the disparity in health outcomes for socioeconomically disadvantaged groups will only widen.