Abstract
Telehealth and digital health more broadly have become two of the fastest growing IT sectors in the world. They have the potential to transform lives everywhere, often before regulation has had the chance to catch up to everyday reality in healthcare. This chapter is grounded in clinical practice occurring at the time of writing and discusses at a high level regulatory issues in telehealth. This chapter argues that complexities regarding regulation over clinical applicability, patient identification, bandwidth, and funding mechanisms, as well as data storage, jurisdiction, and usage should not prevent uptake of telehealth and digital health given the clinical benefits of telehealth in countries such as Australia and internationally.
TopIntroduction And Background
Telehealth and digital health more broadly have significant potential to overcome shortcomings in the health system that affect people’s lives through improving accessibility and efficiency of treatment, which ultimately improves effectiveness of treatment, as exemplified below in Table 1.
Table 1.
Health system wide limitations that can be overcome by telehealth and digital health
| Issue | Problem | Cause | Comments |
| Rural access | Rural people in Australia have up to 4 years less life expectancy than urban dwellers | Lack of access to health services in rural areas is a contributing factor | Online consultations overcome this barrier by enabling patients to see practitioners online through video conferencing facilities |
| Waiting times | Patients can wait months to see a practitioner of their choice in private practice and years for elective surgeries in public hospitals | The structure of the healthcare sector: most practitioners do not need more patients as they are busy enough with their existing patients, but waiting lists show patient populations need more treatment, with practitioners not necessarily located optimally to patient need | Practitioners can see more patients per day with efficiency tools such as:
• Efficiency-driving electronic patient and practice management systems
• Patient-driven personal health records enable patients to complete health tracking and administrative tasks which make each appointment more efficient
• Apps that enable patients to self-diagnose and self-treat similarly ease pressure on private practice.
• Online consultations can overcome mismatched practitioner-patient locations by making location obsolete where online consultations are practical and clinically effective |
| Emergency medical record access | Patients can have adverse reactions if treated by doctors who do not know their medical histories | Lack of access to patients’ medical records with records held in multiple locations | Online medical records that are accessed in times of emergency overcome this by providing treating doctors with up to date medical histories of presenting patients |
| Dependence on service providers for medical devices | Patients have been dependent on pharmacists and practitioners to provide and to customise their devices, before patients can begin using them | Devices have had to be customised manually to each patient’s needs and patients have not been able to do this themselves | A burgeoning opportunity is for patients to self-customise devices, saving patients money, practitioners time so they can treat more patients and enabling speedier use, thus ultimately easing pressure on the healthcare system |
Key Terms in this Chapter
HIPAA: Health Insurance Portability and Accountability Act of 1996, and it is United States legislation that provides data privacy and security provisions for safeguarding medical information. It is not applicable in Australia.
Online Consultations: The treatment of patients using video conferencing technologies.
Patient and Practice Management Systems: Software (either installed or online) used by practices and practitioners to manage their appointments and bookings, clinical billing, financial reports, and patient records.
Digital Health: The use of the internet and of electronic means to manage health data, healthcare, and health services.
Australian Privacy Principles: The privacy principles that regulates how personal information is used in Australia.
Data Jurisdiction and Storage: The country/region in which the server on which data is stored is located.
Practitioners: Clinicians in private practice (rather than in hospitals or other institutions), specifically general practitioners, medical specialists and allied health practitioners. AU15: I added this in place of a footnote
Health Informatics: Design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning, including data usage and analytics.
Personal Health Record: A health record where health data and other information related to the care of a patient is maintained and/or accessed by the patient.