Government tackles telehealth standards

The Federal Government and its e-health transition authority will soon issue a draft position paper outlining technical standards for those looking to participate in its new telehealth rebates scheme.

Linked gallery: Photos: Health Informatics Conference 2011

The Government introduced the $620 million scheme on 1 July in a bid to improve Australians' access to medical specialists from rural, regional and outer metropolitan areas.

Medical professionals lodged more than 140 claims in the scheme's first month, despite having no official clinical standards and limited technical guidance so far.

The Department of Health and Ageing planned to issue a draft position paper around technical standards to the IT industry and healthcare provider associations in “coming weeks”.

“Telehealth is millions and millions of different things,” the department's chief information and knowledge officer Paul Madden told the Health Informatics Conference last week.

“We kicked off some work a couple of weeks ago to develop a position paper to describe the standards we would use and identify any gaps [in existing standards].

“Preliminary work is complete, and the overall conclusion is that there are enough standards at the moment to enable the use of telehealth.”

When launched, the Department's new document would complement recommendations on its MBS Online website, which called for the use of standards from United Nations ICT agency ITU.

Penny Shakespeare, assistant secretary of the Department of Health’s Medicare Benefits Branch, said the Government aimed to “remain agnostic in regards to technology”, but promoted a standards-based approach to ensure interoperability.

While some industry members have expressed concern that medical professionals could receive $6000 grants for doing little more than making a Skype call, Shakespeare said the grants were not about defraying IT costs.

“None of the benefits of the telehealth service accrues to the doctors,” she explained, noting that Australians living outside of metropolitan areas had most to gain.

“We have to convince doctors who have very busy practices ‘what’s in it for me’,” she said.

Standards from the industry

For healthcare providers, the Government's technical guidance (Madden shied from using the term ‘guidelines’) was only one consideration among many.

Madden said although the Government was wary of being seen to support proprietary objectives, there may be a need for more detailed technical requirements should telehealth become more complex.

"My position is that if there are standards that exist, let's adopt them and condone them, as opposed to creating additional ones which are artificially generated," he told the conference.

"If industry can sort this out, let's let them do that."

Standards Australia planned to define a set of telehealth standards and benchmarks for clinicians in this financial year (pdf).

Separately, the Royal Australian College of General Practitioners (RACGP) last week launched an implementation guide to "the most appropriate technical solutions” for video consultations in general practices through its recently established technology enterprise, RACGP Oxygen.

The college, along with the Australian College of Rural and Remote Medicine (ACRRM), also had Government funding to develop clinical standards that defined duty and standards of care for telehealth.

The RACGP's e-health spokesman Nathan Pinskier said RACGP Oxygen’s work was separate from the college’s clinical standards project, with the former focused on “operational aspects of video consultations” and the latter on clinical safety and quality.

Shakespeare said the clinical standards development efforts were funded from the $35 million the Government had set aside for telehealth training and support programs.

Regulation of clinical standards would remain in the remit of professional organisations, in accordance with professional standards legislation in various states.

Exclusive group

IT industry sources have complained of being excluded from the RACGP’s industry consultations, an exclusive group that included Microsoft, IBM, AIIA, Optus, Telstra, Medtel, Polycom, Attend Anywhere, Medibank Health Solutions, NEHTA and others.

One source said participants of the first meeting discussed forming a company that would regulate aspects of the telehealth program and certify practitioners.

Minutes of the meeting were not publicly available. An RACGP spokesman said it would “provide members and other stakeholders with further information in regards to the standards development as the project progresses”.

RACGP's clinical standards for telehealth would be launched in October as an addendum to its existing ‘Standards for general practices’, which pertained to qualifications, rights and needs of patients, and practice management.

The college sought comments from its members on a draft of the addendum until 5pm today.