Telehealth: making healthcare accessible

Online platforms are partnering with GPs and pharmacies to allow rural and remote patients – and those looking for convenience or immediacy – to connect with a practitioner around the clock

As with most industries, the internet is changing the face of healthcare.

Over the past few years, companies have been popping up that are offering patients online access to general practitioner services from the comfort of their home.

Some of these services allow people to gain a medical certificate or prescription without even directly speaking to a doctor – just fill out an online questionnaire that is reviewed and approved by a doctor behind the scenes, and then have the medicines posted to your home.

However other companies are providing more comprehensive telehealth services, requiring patients to consult face-to-face with a doctor using video chat before being able to gain a prescription, referral or medical certificate.

For example, app- and web-based platform Instant Consult offers 24/7 access to telehealth consultations with an Australian-registered doctor.

They don’t allow patients to merely pay to purchase medical certificates or prescriptions.

Consultation cost is based on time spent with the doctor, after which they may provide diagnosis, treatment plans, prescriptions, medical certificates and specialist referrals.

“You’re paying for the doctor’s time and professional advice, not the outcome of the consultation,” says co-founder Travis Brown.

“A patient may ask for a medical certificate and then the doctor may talk to them and further find out that they need some medication, so they might get a prescription and a medical certificate in the same consult.”

Unfortunately Medicare does not cover telehealth services from GPs to patients, and thus the service is completely private, co-founder Bianca Brown points out.

“There’s no bulk billing, no rebate available on these types of consults. It’s different with specialists, our service is GP only so for patients who use it there’s no rebates available,” she tells AJP.

Instant Consult charges $35 for a brief consult (less than 10 minutes) up to $105 for a prolonged consult (more than 40 minutes).

They are hoping that telehealth consults with GPs will eventually become a bulk-billable item.

“There’s definitely a need for it, especially in some of these rural and remote areas where no experienced doctors are willing to travel to and work there,” says Ms Brown.

“Their access is just so limited that it is a shame that it isn’t as affordable as it could be. We have tried to keep our pricing as low as possible to retain doctors to work on the site.”

Ms Brown says the platform has proved to be “extremely popular” with GPs, since the type of work allows them to work flexible hours from home.

“We thought finding doctors would have been one of the biggest obstacles we’d have,” she tells AJP.

However after exhibiting at several Australian medical conferences, they were overrun with interest.

“We ended up filling a timetable quite quickly and we’ve now got a backlog of doctors who want to work on the platform as soon as we’ve got the consult numbers to give them,” she says.

“Currently we’ve got one doctor online at all times, obviously rotating shifts between numerous doctors. Some doctors work four hours a week, some work 40 hours a week, it just depends on what shifts they wanted to take.”

Ms Brown says they see a mix of patients who have differing reasons about why they might wish to use telehealth services as opposed to seeing a doctor in person.

“On one hand we’ve got a group of patients who love the convenience of it, they can’t get in to see their normal GP or they don’t want to clog up the emergency department at the hospital. So there’s those patients who want the convenience,” she says.

“Then we’ve got those patients whose access to healthcare is quite limited, so we’ve got rural and remote patients where a GP may only be in their town for two days every two weeks.

“However they’ve got a local pharmacy where they’ve got medication that they can’t access it without that prescription.”

Telehealth and pharmacy

Platforms such as Instant Consult are now partnering up with pharmacies to allow patients better access to healthcare and prescription medicines.

“We have a mutually beneficial relationship with pharmacies across Australia,” says Mr Brown.

“We need to refer prescriptions onto pharmacies, so it’s a streamlined process.”

Pharmacies register with the service, and during consultation the doctor will ask the patient their location to find out the closest pharmacy or where they wish to pick up their prescription, he explains.

“Like any surgery the patient gets to choose where to pick up their medication from and that’s what the relationship is there.

“So we can send that directly to the pharmacy, the doctor will usually give the pharmacy a call. The patient can then go in and pick up their prescription and the doctor signs and sends the hard copy in the post on the same day.”

Patients can also have the consultation in the pharmacy if they wish to.

Instant Consult helps pharmacies with setting up a computer in a private consult room, with the webpage or app ready to go and staff trained to assist the patients.

“If they wish to use that they help them get set up and then they can have a private consultation in the room with the doctor, and get the immediate result,” says Mr Brown.

“If a customer is in a pharmacy and they know exactly what they want, or it’s a prescription they commonly get from that pharmacy, they can retain them in-store by recommending Instant Consult to then send that script directly back to them,” says Ms Brown.

“So it works as a referral on both parts, they refer us to the patient to get the script, and we refer them back with the prescription. It retains the customer in store for the pharmacy.”

“We’ve got a really good relationship with a lot of pharmacies,” says Mr Brown.

“Some recommend us to their patients, especially when there’s no alternative for them to see a doctor, whether that be because it’s late in the evening and no GP is open and they need their prescription, it’s run out of date or they didn’t realise that the medication they needed required a prescription, they may be travelling interstate – any of the reasons why they haven’t got their prescription or can’t get in to see a doctor,” he says.

“With rural patients, we get phone calls and emails all the time from happy customers because they just couldn’t get in to see a doctor because their doctor was not in town for a week, and they were able to speak to one of our doctors and visit one of the rural pharmacies we work with [to pick up their script].”

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