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Time to see the doctor? It’s just a click away

The demands on health services are enormous. Telemedicine can take some of the pressure off for patients and practitioners.

Dr Ross Kirkman is a psychiatrist in beautiful Tasmania… and a busy one.

Until three years ago he left his Hobart home for three days every week and flew to Burnie in the north west of the state to see patients.

“Then the airline went broke, so I drove,” he says. “But I got sick of that and after a major accident decided I had to do things a different way.”

That different way is telehealth. He now sees all his patients over the internet.

“In general I probably see 600 new patients a year,” he says. “I am sitting in a room and I treat patients over Skype. They are usually in a GP’s office and I am writing notes during the session which I can email to the GP. The GP will then prescribe medication if necessary.

“Most of my patients are in Tasmania but there’s no reason not to see people interstate."


Dr James Freeman at work at GP2U. Photo courtesy of GP2U.

"I have one patient on a remote cattle station in Queensland and the nearest town is an hour and a half away.”

Dr Kirkman is not alone in recognising and servicing the big demand for mental health services in rural and remote areas.

Psychiatrist Dr Ingrid Butterfield also practises entirely via telehealth. She treats patients from rural areas as far afield as North Queensland from her office in Canberra.

“I have patients who really struggle with mobility,” she said. “I have one patient who is bipolar with four children. Yet she is four hours away from specialist treatment by car. She just can’t get there. Two years ago when I started seeing her over Skype she couldn’t hold down a job. Now, with treatment, she has gone from that situation to full-time work.”

Dr Butterfield is just one of the doctors available through Dr James Freeman’s brainchild GP2U, a virtual medical centre based at Battery Point in Hobart, Tasmania.

The operation, which operates via a service over the NBN, provides access to treatment online from GPs or specialists whenever you need it, from wherever you are.

You simply book an appointment online and go to the virtual waiting room, where a doctor will call you.

“If you are going to find centres of excellence you are either going to have travel to them or attend them virtually,” says Dr Freeman. “The NBN is a valuable aid to our infrastructure as it provides access to much better quality video conferencing.*

Telehealth is a virtual return to GPs and specialists making home visits, which died out because there was no financial incentive for doctors, says Dr Freeman. It’s also an opportunity to make medicine more efficient.

A lot of post-operative care could be handled via the internet to save patients a journey, he says, such as checking on a wound healing.

“We are doing 20,000 consults a year at the moment, which is not huge,” he says. “Growth has been about 200% per annum across time. It’s been reasonable but it’s still a small business.”

Psychiatry and weight loss are two popular services offered. But getting the word out about telehealth is an uphill battle, he says, despite the demand for it.

“Telemedicine is going to come because we have some massive financial things to deal with,” he says, pointing to Australia’s ageing population and the demand for mental health services in rural and remote areas.

In Tasmania, Dr Kirkman says he is the only psychiatrist practising exclusively through telehealth.

“When I look at the risk of domestic violence I think I have made a difference to the north west of Tasmania by providing a different service. But this way of working remains very under utilised. Many psychiatrists prefer to have patients come to them.

“I think the NBN will make a significant difference. Sessions with clearer links make a difference. I suppose the people who will take it up are the new trainees. Rather than compete with psychiatrists in Sydney’s North Shore or in Melbourne, where you can’t throw a rock without hitting a psychiatrist, they could provide services to rural areas and they would not only be very busy because of the demand, but they’d get 50 per cent more per consultation, so financially it makes sense. All you need is a decent internet connection.”

Useful links:

Forbes Insights: The Virtual Doctor: How data networks are extending the reach of medical care in the digital age

The Australian Telehealth Conference takes place in Sydney in 23-24 April 2015

The Australian e-Health Research Centre

Telehealth in the Home Project

* Your experience including the speeds actually achieved over the NBN depends on the technology over which services are delivered to your premises and some factors outside our control like your equipment quality, software, broadband plans and how your service provider designs its network.

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