Australia - Telemedicine tauted as a killer app on NBN

[the australian] JULIA Gillard's $392.3m splurge on telemedicine is a move that does three desirable things for Labor all at once, writes Adam Cresswell.

It will appeal to rural voters, who have long faced great difficulties in getting access to specialist health, and who have felt ignored in the health reform discussions so far.

Also, the promise of video consultations in the middle of the night, to be available to Australians nationwide from July 2012, will sound very appealing to families, at least until they realise they will first need to have suitable web-ready cameras and a superfast connection.

Second, the policy makes it easier for voters to see what benefits the expensive and controversial National Broadband Network will bring, even though, paradoxically, the promised rural consultations do not depend on the NBN's rollout and are likely to pick up rapidly as soon as the funding begins in July next year.

And third, the announcement corners Tony Abbott, since he will find it hard to respond to what is likely to prove a popular policy that relies to some extent on the NBN and Medicare Locals, both of which the Coalition has already promised to scrap.

But there are potential pitfalls in the telemedicine approach, and careful implementation will be needed if a returned Labor government is to avoid them.

For one thing, online consultations are not likely to replace face-to-face care except for those in extremely remote settings, since a doctor cannot palpate a virtual patient's liver or examine their throat.

Some doctors may also be cautious about getting involved, if they fear they stand a greater chance of being sued for missing a problem they would have been more likely to detect face to face.

Reflecting these concerns, the Australian Medical Association is calling for doctors to have the right to decide whether an online consultation is appropriate, and seeking assurances that online services will not compromise patient safety.

The policy small print says several times the details will be worked out in consultation with the profession - a sign that it at least recognises these dangers.

Clever policy appeals on three fronts