Abstract: Video consultation is an important aid to improving access to health services for rural and Indigenous Australians. However, from our combined experience in health care provision in rural and Aboriginal communities over many decades, we have observed the following persistent reasons for poor uptake of telehealth. - Technical/logistical constraints: Existing technology has made access to telehealth difficult. Video consultations have required dedicated rooms and personnel including a booking clerk and an IT support officer; - Cost inhibitors: Existing technology, in many health facilities, utilised expensive legacy technology, costing up to $117 per hour in some areas. Legacy video conferencing technology1 also required significant capital investment, some costing millions to establish; - Insufficient Medicare funding: Because there has been limited access to Medicare funding for specialists and other practitioners to undertake video consultations, the technology has generally been utilised by staff specialists rather than private practitioners; - Resistance by staff and patients: There is considerable anecdotal evidence of perceived patient and staff resistance to telehealth, and more particularly with mental health clients, the elderly and Aboriginal patients; - Disinterest/opposition by health practitioners: Some practitioners are concerned that video consultation has the potential to damage doctor-patient relationships, increase risk and may be inappropriate for multidisciplinary team cooperation; and - General lack of organisation support: Some organisations have been more resistant than others to embrace video conferencing, due to the logistical challenges of implementing the technology and competing priorities.
Elizabeth Barrett, Michael Edwards, Sharif Bagnulo, Shane Hatton, Rose Ellis, 2013, Virtually Intouch—an evaluation of desktop telehealth in rural and remote New South Wales, Conference Paper, viewed 19 August 2022, https://www.nintione.com.au/?p=3116.