Nilmini Wickramasinghe, Professor Digital Health, Deputy Director Iverson Health Innovation Institute Swinburne University of Technology/Epworth Healthcare explores the importance of telehealth during COVID-19 and how it can be harnessed to drive efficiency and improve care outcomes. Below, Nilmini shares her insights into this and more.

What are the considerations for security of data and privacy for consumers and patients when it comes to Telehealth implementation? 

"In the current COVID-19 context many of the security and privacy issues have been (or have had to be) pushed to aside as rapid deployment was required. There are many unintended security/privacy issues ranging from other people either on the clinician side or patient side able to hear the telehealth consult as it is currently in the home to the level of security for transfer of patient data.

Again since most of us are currently working from home privacy and security protocols probably vary hugely unlike if consultants were running the telehealth consult from the hospital or medical office. This leads to the whole issue of the general level of data privacy and security and what we believe is a minimal acceptable level and how this should be achieved.”

What are some of the financial implications for hospitals and health organisations? How can the business value of Telehealth be valued to generate buy-in?

“Again in the COVID-19 context there was really no choice ...so the business value becomes with telehealth versus no consult. as we get back to a more normal environment we need to unpack the unintended consequences such as workforce impacts - in the current environment several nurses have had to step up and provide needed tech help/assistance - this has created a significant work force issue for them.

We need to compare clinical outcomes and the patient experience with and without telehealth - some areas of clinical care lend themselves better to telehealth than others. We also need to factor into the account the IT “burden” - support and staffing and even the infrastructure. And finally form the payer angle - are health insurance companies going to continue to reimburse for telehealth post COVID-19 lock down and what would such a model look like.

Perhaps high risk people are recommended to consult via telehealth and this may reduce risks of contracting infections etc but they may not have the optimal richness of a face to face clinical consult By considering all stakeholders, technology, people and process issues then we can begin to formulate a suitable model to assess more accurately the business value of telehealth. We also need to think about the sustainability of these telehealth solutions.” 

What strategies can be used to prepare and up-skill patients to be comfortable and confident enough to use telehealth platforms? Especially for the digitally challenged?

"Indeed the general population needs to have a certain level of digital health literacy - we need to decide what that minimum level should be and then develop community based programs to ensure all have the correct exposure and thus develop the appropriate level of digital health awareness. in particular, we must ensure vulnerable groups e.g. disabled, elderly , non-English speakers have the appropriate level of digital health literacy."

Where do you start with finding a telehealth solution provider?

“I think this depends on the needs, services that the specific telehealth scenario requires - is it a consult? what is the clinical domain . I do not think there is a one size fits all approach but it would be good to have key systems vetted and reports on the user experience to help people decide. E.g. is it as simple as using GOTO Meeting and have user testimony on how this works in a particular context. To the best of my knowledge there is no comprehensive evaluation or listing of telehealth solution providers.”