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How pandemic may have forever changed our health system - for the better

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The pandemic that was expected to overwhelm the system has instead transformed it – hopefully, to the patients’ benefit.

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Non-urgent elective surgery was postponed amid fears thousands more COVID-19 patients would need beds. The surge never came, but as elective surgery now resumes – subject to local factors, including the availability of Personal Protective Equipment – hospitals are overhauling how they operate.

Queensland Health director-general Dr John Wakefield expects a six to 12 month holding period, as Australia works to stop the spread of SARS-CoV-2 and avoid uncontrolled outbreaks. In that time, there may be unprecedented innovation of practices and funding models.

“We need to be ready, in case, but we need to get back to a new normal,” Wakefield told InQueensland.

“And we’ve got a tremendous opportunity now to not necessarily go back to what normal was.”

One thing Wakefield expects to change is routine appointments with specialists, for example during the lead-up to elective surgery. He says the pandemic has shown the risks and inconvenience involved with having people come into a busy hospital for a consultation.

For years, there have been calls to extend Medicare rebates to so-called telehealth consultations, which are delivered remotely with the aid of technology. The need to socially isolate people, especially those most vulnerable to COVID-19, forced the federal governments’ hand, and virtual consultations are now embedded in the system.

“Clinicians like it, patients like it, so we really want to harness that and expand it,” Wakefield said.

Last week, in announcing another $48.1 million in federal funding for mental health, Prime Minister Scott Morrison said he was heartened by data suggesting more people were getting help through telehealth after the initial disruption to services.

“It was particularly encouraging to see that with the advent of telehealth, we are now seeing the number of presentations and consultations occurring for mental health now back to levels that were being experienced, pre-pandemic, half of those being done through the telehealth mechanism,” Morrison said.

For some people, telehealth may be as helpful as in-person consultations, potentially more convenient, depending on their condition. Federal Health Minister Greg Hunt said a forecast increase in mental illness, and fears of more suicides, meant it was important to reach people by whatever means possible.

“The stress of concerns about health, the loneliness of isolation, anxiety about a job, a small business set of finances, the mortgage, all of these pressures which come with the pandemic have created specific mental health challenges,” Hunt told journalists.

“Everyone here will have seen or felt it amongst their own families or friends or circles the pressures that are in place right across Australia.”

It is unclear how long the alternative funding arrangements, which include different formulas for public hospitals and aged care, will remain. Wakefield, for one, is keen for innovative approaches to continue.

“We are desperate to work with the commonwealth on that,” Wakefield said.

“Sometimes it takes a crisis to change those models and underlying funding levers.”

Wakefield suggested the increasing pressure on hospitals was unsustainable, and more work was needed to keep people out of hospital, through public health, community health, prevention and home-based monitoring and treatment.

To support virtual consultations, Queensland now allows digital image scripts, so people can have medications prescribed by their regular doctor, and dispensed and delivered by their usual pharmacy, without leaving home.

Queensland Health Minister Steven Miles said the measure – in place until September at least -would assist patients and clinicians and potentially reduce infections during the pandemic.

“Telehealth consultations delivered by Queensland Health clinicians have increased during the COVID-19 response,” Miles said.

“These patients will now have their prescription flow handled by modern technology as the old-school fax and follow-up between doctors and pharmacies is replaced by digital copies of prescriptions sent by a choice of modern communication streams.”

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