Healthcare delivery using advanced technology has been promoted for years. The advantages of telemedicine include to provide or increase the accessibility which previously had been inaccessible or unavailable, to reach to a wider population and to promote health through awareness, education and outreach (Almathami et al, 2020). The benefits anticipated from telemedicine include cost-effective healthcare services and improved health outcomes. However, despite the numerous advantages and anticipated benefits telemedicine is not widely used. Barriers have been recognised in both information and communication technologies as well as the management of the telemedicine services. The aim of the essay is to discuss the various barriers to the uptake of telemedicine in Australia.
Telemedicine has been described as technology-based healing from distance and it has promising applications in various fields like aged care, dentistry, neurological issues, counselling, mental health etc. The applications of telemedicine can be broadly categorised according to the interaction between the individuals involved and the timing of information exchanged (Scott-Kruse et al., 2016). “WHO identifies some common elements that Telemedicine should include: providing some sort of clinical support, overcoming a barrier of proximity, using some sort of information and communications technology, and for the overall benefit of the patient” (Scott-Kruse et al., 2016). For several years, telemedicine had been aimed at bridging the gaps and catering to the hard-reach population while providing them easily accessible healthcare.
Information and communication technologies barriers include internet connectivity, lack of Medicare facilities available through telemedicine and lack of infrastructure. Internet connectivity is a critical component of healthcare delivery through telemedicine and hence, can prove as the biggest barrier for healthcare delivery in the remote and rural areas of Australia. The most frequently identified barrier as per the study conducted was lack of adequate internet (Cummings et al., 2019). Telemedicine using high quality satellite based technology has been established to be an innovative and improved approach. However, the lack of awareness about such services and how they can be put to use, in the remote and rural areas, was identified to be contributing to the lesser uptake of telemedicine. The lack of basic infrastructural amenities to support telemedicine such as lack of broadband connection, lack of a computer, not having software compatible with the camera and lack of devices with a camera were identified (Almathami et al., 2020).
The management based barriers for telemedicine include lack of time and funding, lack of equipment skills, preference for the traditional approach of the treatment and inability to assess the complicated presentations of different symptoms or health-issues (Estai et al., 2016; Caffery et al., 2017). Lack of funds directed by the government and further by the healthcare organisations towards healthcare delivery through the medium of telemedicine has been identified as the key barrier. The packed schedules of the healthcare staff and no additional benefits or incentives for providing healthcare services through telemedicine has been another major barrier. Apart from this, many healthcare professionals lack the knowledge and skills to use the equipment and applications created for telemedicine. Skills necessary to use the equipment or the understanding of how to learn the existing equipment in new ways is essential. The generational gap has been recognised to be causing an inclination of the older general practitioners and other healthcare providers to stick to the traditional means of healthcare delivery (Caffery et al., 2017). Symptoms that cannot be assessed and analysed over telemedicine and need proper diagnosis and physical assessment such as dental or orthopaedic problems are also a barrier for the uptake of telemedicine.
Provision of paediatric care through telemedicine aims at the same facilities as provided to the adults, however, numerous factors add an additional layer of difficulties and barriers while delivering care to the paediatric patients (Bailey et al, 2019). The acceptability of the care and the trust on the suggestions advised through telemedicine by the caregivers and parents of the children are essential to work towards the positive outcomes directed by paediatric care. Therefore, the technological advancements need to be well accepted, perceived and trusted by the healthcare consumers which can only be brought about by patient education and awareness.
To address the barriers in the future, it is essential to primarily aim the attention of the government and policy-makers towards the provision of healthcare delivery through telemedicine. The healthcare organisations should provide schedules that allocate the time of the healthcare professionals towards reach a wider and inaccessible population through telemedicine (Almathami et al., 2020). Improving the connectivity and internet services by high quality satellite technology and better broadband connections. The skills for equipment usage can be provided to the healthcare professionals through seminars and training. Arrangements should be made directed towards an increase in awareness, engagement and promotion of healthcare services by healthcare consumers through campaigns and programmes. The segment of healthcare professionals, majorly the older generation of doctors and general physicians, should be provided with an opportunity to attend the seminars based on telemedicine to understand the benefits such as ease, better reach, cost-effectiveness and improved health-outcomes through telemedicine (Estai et al., 2016). Incentives to be levied for the healthcare professionals engaging in the telemedicine services. Referrals to be made for the complicated symptomatic presentation to the nearest primary health-care centres and reports of the diagnostic tests to be shared and analysed through various applications of telemedicine. Efforts should be directed at increasing the facilities and provision of care provided by Medicare through telemedicine.
From the past decades, telemedicine has been bridging gaps to provide accessible healthcare. Telemedicine has been recognised as a cost-effective approach to improving the health outcomes of a wider range of population, especially those in the rural and remote areas. The barriers identified belong to two main categories, information and communication technologies issues and management issues. The information and communication technology barriers include lack of internet connectivity, lack of infrastructure and lack of Medicare facilities available on telemedicine. These issues usually prevail due to lack of broadband connection in the inaccessible areas, poverty in the rural areas and lack of awareness of the rural and remote population. The management issues that pose as a barrier include a lack in funding and time, lack of equipment skills, preference of traditional approach of the treatment and inability to assess the complicated symptoms or complications of the disease that require physical evaluation.
Almathami, H.K.Y., Win, K.T., & Vlahu-Gjorgievska E. (2020). Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: Systematic literature review. Journal of Medical Internet Research, 22(2), e16407.
Bele, S., Cassidy, C., Curran, J., Johnson, D.W., Saunders, C., & Bailey, J.A.M. (2019). Barriers and enablers to implementing a virtual tertiary-regional Telemedicine Rounding and Consultation (TRAC) model of inpatient pediatric care using the Theoretical Domains Framework (TDF) approach: A study protocol. BMC Health Services Research, 19, 29.
Caffery, L. J., Taylor, M., North, J. B., & Smith, A. C. (2017). Tele-orthopaedics: A snapshot of services in Australia. Journal of Telemedicine and Telecare, 23(10), 835–841.
Cummings, E., Merolli, M., & Schaper, L.K. (2019). Digital Health: Changing the way healthcare is conceptualized and developed. Netherlands: IOS Press.
Estai, M., Kruger, E., Tennant, M., Bunt, S. & Kanagasingam, Y. (2016). Challenges in the uptake of telemedicine in dentistry. Rural and Remote Health, 16(4), 168-172.
Scott Kruse, C., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2016). Evaluating barriers to adopting telemedicine worldwide: A systematic review. Journal of Telemedicine and Telecare, 24(1), 4–12.
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