“Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate.”
“When I think about the COVID-19 pandemic, this 2007 quote made by Mike Leavitt, Secretary of the US Department of Health and Human Services, immediately comes to mind,” says Dr Centaine Snoswell.
As a Research Fellow in Health Economics with UQ’s Centre for Health Services Research, Dr Snoswell spends most her time examining ways to improve the sustainability of Australia’s health system by changing the way services are provided. The main focus of her work is evaluating the effect of telehealth and pharmacy service interventions in our health system. In 2020, Dr Snoswell’s telehealth work has been engulfed by COVID-19, a dangerous global public health emergency.
“Every preventative measure we implement and follow today, has the potential to reduce emerging COVID-19 cases needing hospital care next week. When a viral pandemic strikes, the time to act is now,” Dr Snoswell insists.
“My role involves giving decision makers the evidence they need to create an effective medical strategy to manage health crisis and resources at the same time. For example, research on the effectiveness and cost of telehealth was already available when COVID-19 erupted, so we didn’t need a lot of new information to implement the service in Australia. What we needed was rapid upskilling of our health professionals and access to appropriate technology,” Dr Snoswell explains.
It’s evident that digital technology offers Australia’s health system enormous opportunities to improve its agility and flexibility, but we’ve barely tapped into what’s possible.
“The biggest benefit we’ve gained from using digital technology during COVID-19 is the ability for medical professionals to interact with others online, rather than in-person, which reduces everyone’s risk of exposure and transmission.
“This technology allows us to rapidly transmit mass information, which is critical when preventative measures are changing every day,” Dr Snoswell says.
“It’s crucial the messages we disseminate to our front-line health professionals are brief and clear, and come in an accessible format with links to sources and more detailed advice.
“For instance, we can send information direct to the health professional’s main device, like their mobile phone or tablet. This removes the need for them to go and find a networked computer when it’s busy and they need to access information updates via an intranet or email.
“With digital technology we’ve also been able to quickly communicate information to large numbers of people, and maintain social distancing measures without isolating people. Mobile phones, video-calls and chat programs, have allowed us to triage potential COVID-19 cases and direct them to a testing station, where there are appropriate protection measures in place for staff and other patients,” Dr Snoswell says.
“Any type of technology that we can use, like phone, text or telehealth, to reduce in-person contact during COVID-19 should be used. And, despite the urgency of this situation, where possible, clinicians and patients must use platforms that comply with privacy and security guidelines.
“In Australia, we’ve historically turned to video-conferencing when people have mentioned telehealth, but in a lot of other countries, doctors communicate with their patients through secure online dashboards, emails, and other media.
“Where we can, we need to be using technologies that flip the paradigm of care – rather than one clinician being in contact with every patient individually to collect and disseminate information. We should have one clinician using digital technology to contact multiple people at the same time.
“For instance, negative test results that don’t require action could be sent via text or email to a patient, rather than using a standard phone or in-person consult.
“The COVID-19 pandemic has shaken the foundations of all Australians, and started the ball rolling for lots of immediate changes in the way we deliver health care.
“I think that sustained uptake depends on the experience of patients and clinicians during the crisis, because experience is integral to telehealth uptake. These digital interventions, and their funding, may or may not continue after this public health emergency is over,” Dr Snoswell says.
“When COVID-19 has ended we need to review what worked and what didn’t, so we can identify training and infrastructure needs, and make sure we’re better prepared next time.
“One of the key changes is likely to be the integration of digital health training for all clinicians and continuing professional development.
“We also need to streamline health services from a one-to-one interaction to an asynchronous interaction, like remote monitoring of chronic diseases, monitoring low-risk patients in isolation and triage of potential COVID-19 cases.
“Over the next few decades, healthcare around the globe will change dramatically. We’ll see advanced artificial intelligence redesigning decision-support tools and patient triage, virtual reality reshaping medical interactions, genomics enabling precision medicine, and 3D printing being more widely used for prosthesis and devices.
“The changes we make now and after COVID-19 will pave the way for the integration of future digital healthcare interventions so that we can advance our quality of healthcare and the wellbeing of all Australians.”
Dr Centaine Snoswell
Dr Centaine Snoswell