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Telehealth: The best is yet to come but should platforms be owned by the state?

The use of telehealth peaked with the pandemic and is now tailing off across most of Europe. Most of the medical profession got stuck using ‘primitive telehealth’ like Skype so didn’t see its full productivity potential. Austria has neglected the market providers and started to build its own – and there’s a very strong argument for others to follow suit.

As a manager of a Danish public hospital tells us: “Telehealth has gone from 10% to around 30-40% of all consultations. My fear is that it will now fall back when it should be accelerating to about 60-70%.” It should be accelerating, he says, because it’s more productive. “For patients, it means no waiting rooms, no travel. For doctors the ability to be far more productive. We’ve seen patient/doctor sessions going from 3-4 to 6-8 an hour with telehealth.”

Official data from the Danish doctors union (PLO) shows that videos consultations fell back down to an average of 3,000-4,000 a week through July compared to a peak of 24k in the week beginning March 30.

“An important point to bear in mind is that most doctors have only ever experienced a very primitive form of telehealth,” says our public hospital manager. “Many will only have experience with vanilla Skype or its equivalent. If they have used more advanced systems they may well have been unaware of all its functionality.  And the next three years will see huge steps forward as new apps such as skin cancer scans or natural language which can detect possibly mental ill-health are added to the telehealth tray.”
All of which leads to a final thought. Austria has recently launched its own national telehealth platform. Government sources there tell us the plan is for doctors and hospitals to use this system and this system only. Why?
“When we look at other countries we see many telehealth platforms proliferating, often using per capita primary care payment models to grab a slice of the market. But this is madness. Not only does it leave the state with the expensive old patients who are not digitally savvy but it also sheers off data sets.”
The Austrian approach instead is to build a state platform and to then add a whole range of new apps as digital health develops. It is hard for us to fault the logic of the approach. Looking at the data from Denmark: 73% of consultations were completed through its ‘official’ platform in the last week.
Policymakers will therefore be tasked with two difficult problems. The first, the persuade doctors to use telehealth in the first place. The second? To persuade them to use the state-owned one.
We would welcome your thoughts on this story. Email your views to Rachel Lewis or call 0207 183 3779.