The Australian Department of Health has not failed to manage risks in expanding telehealth: a government review

Australia’s National Audit Office has conducted a review of the expansion of telehealth services across the country by the Department of Health and Aged Care in response to the COVID-19 pandemic.

the findings

Based on State auditthe section is short on governance, risk management, and assessment of the expansion of telehealth.

While it made “significant” changes to the Medicare Benefits (MBS) schedule, expanded telehealth services were “only partly supported by sound implementation arrangements.”

The review found that it did not require documentation of major implementation decisions and plans.

It was also noted that the administration did not manage the implementation risks associated with temporary or permanent changes in telehealth services in accordance with its risk management policy. Nor did it conduct a risk assessment of integrity risks, such as provider fraud and non-compliance, prior to implementing the temporary and permanent telehealth provisions of MBS.

So, according to ANAO, it isThe governance arrangements for expanding telehealth services were not “fit for purpose”.

Meanwhile, the state review also found that the administration did not plan to monitor performance or evaluate temporary or permanent telehealth.

“Health has not consistently assessed the effectiveness of telehealth as a response to the pandemic, despite some analyzes of billing data and independent research,” the report stated.

MBS billing data was used to monitor usage patterns of telehealth services under the assumption that telehealth use and billing behaviors were sufficient indicators of successful telehealth implementation. It also does not contain performance targets.

However, the audit confirmed that the temporary and permanent expansion of the telehealth components of MBS had benefited in large part from “robust” policy advice and planning.

During the initial response to the pandemic, the administration quickly reported to the Secretary of Health the costs and some of the benefits and risks of temporary telehealth policy settings. She has also consulted with and advised higher authorities on policies for temporary and permanent telehealth.

After these results, ANAO made some recommendations, which were approved by the department. This includes strengthening oversight systems to implement changes to MBS, incorporating elements of governance such as documentation of implementation issues and resolutions, and planning for monitoring and evaluation. It also agreed to develop procedures that ensure changes to MBS are subject to a structured and documented risk assessment, as well as to finalize its plans for a permanent telehealth assessment.

It agreed only in principle with the recommendation that it consider lessons learned from the introduction of temporary telehealth components as an epidemic response measure for future epidemic preparedness.

In response, the department said it “acknowledges ANAO’s findings while also acknowledging the unique scenario of the emergency health response to COVID-19.”

“The department has achieved its goals of maintaining patients’ access to essential health services throughout the lockdown periods as well as reducing [the] The risk of disease transmission to patients and service providers.

Furthermore, he said he still has to refine and assess the alignment of MBS telehealth elements with contemporary clinical practice through a post-implementation review. This will be conducted by the Mohammed bin Salman Review Advisory Committee, which will report back to the government later this year.

why does it matter

ANAO conducted the review to provide “assurance” on the rapid implementation of health policy changes and the transition from emergency to permanent settings. Rapid implementation of policy changes could increase risks [the] He explained that providing public services effectively and efficiently.

The biggest trend

To provide greater access to health services amid an ongoing global pandemic, the Australian Government has introduced 281 new telehealth components on MBS. In late 2021, the Department of Health announced that the government had allocated funding to deliver subsidized telehealth materials. permanent. However, weeks after this announcement, the government revealed its move to Ending support for 128 telehealth components on Medicare as recommended by the MBS Review Working Group. Later in November, the government reinstated Supporting telehealth psychiatric videoconsultations By providing additional funding in the October budget.

Recently, more than 130 million services have been provided via subsidized telehealth in Australia, based on current Department of Health figures.

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