Telehealth has been hailed as an answer to New Zealand's ongoing problems. The health care crisis, which is particularly severe in rural areas..
But moving health services online can have a variety of unintended consequences that may affect the health of patients and doctors.
Since the pandemic, there was an emphasis on telehealth services – doctor appointments through online platforms or over the phone. This shift in focus is clear on this. Government policy statements Spotlighting telehealth options have grown. Government funding and the rapid expansion of providers.
Telehealth is seen by many as a solution to increase access to care, reduce wait times and streamline services. But the best way My research As it seems, there are downsides to moving care online. These things shouldn't be ignored.
Advantages and downsides of telehealth
According to a recent report, about 900,000 live in rural New Zealand. Rural Health Network. Their health consequences could make for serious reading.
The report found that non-Māori men aged 30 to 44 were 1.8 times more prone to die preventably than their peers living in urban areas. And Māori under 30 living in rural areas were twice as prone to die from a treatable disease than their city counterparts.
As a rural general practitioner based in a distant area of Northland, I see first-hand the disparity in access to healthcare. For example, there was no everlasting doctor for 2 years.
Telehealth has offered some support to our patients and provided relief to overworked doctors.
On the plus side, I not get up 4 times an evening to call out while still having to work the subsequent day. And for a lot of patients, talking to a health care provider over the phone for a routine matter is way easier than traveling 30-40 minutes and waiting at a clinic.
research Telehealth has also been found to be a viable and culturally secure alternative to face-to-face consultation for Māori whanau.
However, mine research Telehealth has been found to disrupt the continuum of care.
Continuity of care, during which a patient has a long-term relationship with the identical doctor. has been shown to have a low mortality rate.. The reduction in mortality because of continuity of care is 8% after two to 3 years and 25% after 15 years.
Putting pressure on other areas
The adoption of telehealth has many other unintended consequences.
Moving care online or over the phone can create pressure to maneuver to other parts of the health care system. This can, for instance, increase the burden placed on rural nurses who need to manage essentially the most complex conditions without the assistance of an on-site doctor.
A recent case of a Heart attack at Dargaville Hospital Where there was no doctor on site it will need to have been very difficult for the nurses and incredibly stressful for the whanau.
research It has also shown how telehealth can open the door to unsafe medical practices, comparable to inappropriate prescribing or inappropriate ordering of medical tests and investigations.
Additionally, telehealth doctors cannot necessarily manage more complex health problems. These eventually push physicians to be managed urgently or in emergency rooms, thereby increasing the burden on these points of care.
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The context is lost.
Telehealth doctors often don't live in the identical area because the patient. This means local context and knowledge could be lost.
I actually have seen patients inappropriately referred to rural hospitals after they must have been referred to larger urban hospitals for higher-level care.
There can also be a more paradoxical problem that may arise. In trying to resolve the workforce crisis, we are literally making it worse.
Telehealth providers are recruiting from New Zealand's already limited doctor pool. This leads to a discount in the general availability of physicians in a position to provide face-to-face care. It's easy to see why that is a gorgeous option for some. Telehealth positions allow doctors to work from home during hours that fit their lifestyle.
Short term pondering
Overall, solutions to rural health don't seem like driven by the agricultural workforce or rural communities. Rural communities want the identical access to health care as everyone else.
From 2023, Health NZ has introduced some measures. To solve the issue of rural health care. These include a NZ$9,100 accommodation allowance for primary care trainees who live inside 30km of their rural GP practice, in addition to cover for local GPs, nursing and rural hospital doctors in rural general practices and rural hospitals. Funding can also be included to offer.
But there are huge health inequalities in rural areas, particularly for Māori, and the funding needed to shut the gap is nowhere to be seen.
The single most vital workforce factor that reduces mortality, continuity of care with an everyday physician, shouldn't be involved in decision-making and policy work.
Instead, continuity of care is ignored because of ongoing disruption within the healthcare sector and the substitution of clinical roles for cheaper and easier options – comparable to telehealth. The government shouldn't be taking note of the investment needed to bring doctors to rural areas.
Importantly, the answer to the agricultural workforce crisis must come from rural communities and rural doctors who've the experience to know what is going to really work.