Webinar 1 COVID-19 and Digital Technology: roles, relevance and risks of using telehealth
24 March 2020
Our journey started with a webinar hosted by the Digital Health CRC, Curtin University, and Latrobe University. Dr. Norman Swan led the panel discussion on COVID-19 and digital technology: The roles, relevance, and risks of using telehealth in a crisis, which attracted over 500 people to sign up within the first 24 hours of registration. Front line healthcare professionals responded positively and enthusiastically as they made up 70% of the 3663 participants. Despite the Australian focus, the webinar attracted participants from 45 countries around the world with 76 participants from the USA, 19 from the UK, 14 from China, and 12 from New Zealand. There were other participants from Afghanistan, Angola, Armenia, Austria, Bangladesh, Brazil, Cambodia, Canada, Egypt, Ethiopia, France, Hong Kong, India, Indonesia, Ireland, Jamaica, Japan, Malaysia, Morocco, Myanmar, Netherlands, Nigeria, Pakistan, Papua New Guinea, Philippines, Portugal, Qatar, Senegal, Singapore, Spain, Sri Lanka, Sweden, Taiwan, Thailand, Turkey, United Arab Emirates, and Vietnam.
Panel speakers
Chair: Dr. Norman Swan (physician and journalist)
Panelists:
- Professor Trisha Greenhalgh (Primary Care Health Sciences, University of Oxford, UK)
- Dr. Amandeep Hansra (GP, Bondi Doctors, NSW, Australia)
- Dr. Neale Fong (WA Country Health Service board chair, and medical practitioner)
- Karrie Long (School of Nursing and Midwifery, La Trobe University and Director, Nursing Research Hub, The Royal Melbourne Hospital, Victoria, Australia)
- Dr. Daniel Stefanski (staff specialist infectious disease physician, Queensland Health, Queensland, Australia
COVID-19 is of global concern and so is the expansion of telehealth as a different way of doing things. Professor Trish Greenhalgh pointed out,
“Where we are now is a trade-off between benefit and harm. All clinical consultations require us to trade benefit and harm and the benefits and harm balance has changed dramatically in the last couple of months, we’ve got three junior doctors on ventilators in London.”
The inaugural webinar covered a broad basis and attracted over 350 questions and comments during the session. Due to the overwhelming response from the participants, the panel did not answer all questions due to time constraints.
This telehealth hub collates resources and tools to help answer the main questions raised by the webinar participants and we believe this is a good representation of what is required to support clinicians and service providers to embark on their respective telehealth journey. A summary of the key points made by each speaker has been summarised by the Croakey Voices in Unpicking some key challenges for telehealth resolution ahead.
01/ Guide to providing telephone and video consultations in general practice
Royal Australian College of General Practitioners (Published March 2020)
RACGP provided guidance for appropriate use of telephone and video consultations in general practice, stated the principles for conducting telehealth consultations and provided practice tips and related resources.
02/ Oxford COVID-19 Evidence Serviceour Title Goes Here
The Centre for Evidence-Based Medicine (Last updated 3 April 2020)
Oxford’s CEBM has committed its skills and expertise in evidence synthesis and dissemination to the effort against COVID-19. This page is updated regularly and contains a broad range of topic areas including the treatment of COVID-19, patients with long-term conditions, what is the effectiveness of PPE? Signs and symptoms, evidence-based ways of assessing dyspnoea, accuracy of home measurements of vital signs, evidence for social distancing, how do you manage pneumonia in older people in a pandemic? What is happening to mortality during the COVID-19 outbreak? Managing older populations in long term care settings etc.
03/ Covid-19: a remote assessment in primary care
Trisha Greenhalgh, Gerald Choon Huat Koh, Josip Car (Published 25 March 2020)
A step-by-step guide to remote physical assessment in primary care with a detailed infographic outlining each step (set up, connect, get started, history, examination, decision, and action.
The focus is on COVID-19 and setting is in the UK, but is a great entry reading for medical practitioners who have not used telehealth before. Click on GO to read the paper.
COVID-19 related resources to find symptom checkers created in Australia can be found in COVID-19 under Special Topics.
04/ Are there any evidence-based ways of assessing dyspnoea (breathlessness) by telephone or video
Trisha Greenhalgh (Published 23 March updated 2 April 2020)
No validated test was found in this rapid view for assessing dyspnoea in an acute primary care setting. The Roth score is not evidence-based and should not be used. Experts have recommended 7 key questions to ask the patient by telephone. There is no evidence validating the use of Roth score, smartphone apps for oximetry, and oximetry devices supplied to patients in a primary care setting.
05/ Digital health technologies
Commonwealth Scientific and Industrial Research Organisation
CSIRO is developing online and mobile technologies to improve access to services and health outcomes. The technology is helping to provide quality, out-of-hospital care to the elderly, people living in rural and remote communities, and patients managing chronic disease.
Delivering healthcare via telecommunications could open up home monitoring of aged care patients with chronic disease, improve health outcome and significantly saving costs.
CSIRO also supports hospitals and health systems with technology to help improve the quality, delivery, and management of patient care.
06/ Surrey Heartlands Primary Care Guidance for COVID-19
Surrey Heartland Health and Care Partnership (Published 15 March 2020)
This guidance document from the UK contains examples of consulting models including a full implementation guide in Appendix A, a total triage guide in Appendix B, and a telephone consulting guide in Appendix C. This document also outlines, in the context of Surrey Heartlands, business continuity planning, daily working rhythm, booking and arrival controls, managing respiratory/fever cases, staff who are at risk, residential home/care homes/housebound.