The Australian National Audit Office has conducted a review of the Ministry of Health and Aged Care’s expansion of telemedicine services across the country in response to the COVID-19 pandemic.
findings
based on In state audits, the department fell short in evaluating governance, risk management, and telemedicine expansion.
While making “significant” changes to the Medicare Benefit Schedule (MBS), expanded telemedicine services were “only partially supported by sound implementation arrangements.”
The audit found no need to document major implementation decisions and plans.
It was also noted that the department did not manage implementation risks associated with temporary or permanent telemedicine changes in accordance with its risk management policy. We also did not perform a risk assessment of integrity risks, such as provider fraud or non-compliance, before implementing temporary and permanent MBS telehealth items.
Therefore, according to ANAO,The US governance structure for the expansion of telemedicine has not been “fit for purpose.”
Meanwhile, the state audit also found that the department did not plan to monitor performance or evaluate temporary or permanent telemedicine.
“Health has not consistently evaluated the effectiveness of telemedicine as a response to the pandemic, but analysis of claims data and independent research have been conducted,” the report said.
We used MBS billing data to monitor telehealth usage patterns, assuming that telehealth usage and billing behavior are sufficient indicators of a successful telehealth implementation. Also, there are no performance targets.
Still, the temporary and permanent expansion of MBS telemedicine items was largely informed by “firm” policy advice and plans, the audit stressed.
During its initial response to the pandemic, the department quickly advised the Minister of Health of the costs and some of the benefits and risks of setting temporary telemedicine policies. We have also incorporated the voices of the highest authorities into our policy recommendations on temporary and permanent telemedicine.
Following these findings, ANAO made several recommendations, which the department agreed with. This includes incorporating governance elements such as strengthening management systems to implement changes to the MBS, documenting implementation issues and decisions, and monitoring and evaluation plans. We also agreed to develop procedures to ensure that MBS modifications are subject to a structured and documented risk assessment, and to finalize a plan to assess permanent telemedicine.
We only agreed in principle with the recommendation that lessons learned from the introduction of temporary telemedicine items be considered as a pandemic response to prepare for future pandemics.
In response, the department said it “acknowledges ANAO’s findings and is also aware of the unique scenario of the COVID-19 emergency medical response.”
“The department has achieved its goal of reducing infections while maintaining patient access to basic medical services during the lockdown period. [the] There is a risk of infection for patients and healthcare providers,” he added.
Furthermore, they said there is a need to improve and assess the alignment of MBS telemedicine items with contemporary clinical practice through post-implementation reviews. This will be done by his MBS Review Advisory Board and will be reported to the government later this year.
why it matters
ANAO conducted the audit to provide ‘assurance’ on the rapid implementation of health policy changes and the transition from emergency to permanent environment. “Implementing policy changes too quickly can increase risk. [the] To provide public services effectively and efficiently.”
the bigger trend
To expand access to health services amid the ongoing global pandemic, the Australian government has introduced 281 new telemedicine items into MBS. In late 2021, the Ministry of Health announced that the government had secured funding to create a subsidized telemedicine item. permanent. But weeks after the announcement, the government announced a move to end support for 128 Medicare telemedicine items, following the recommendations of the MBS Review Task Force. In late November, the government reinstated subsidies for single-billing video telemedicine psychiatric consultations by providing additional funding to his October budget.
Based on current Department of Health figures, more than 130 million services are now provided through subsidized telemedicine in Australia.
