High needs patients give thumbs up to virtual consults

graph and charts showing uptake of telehealthPatients’ ready embrace of virtual health consults across Total Healthcare’s provider network have confounded all expectations throughout the lockdown period.

Just under 16,000 remote consults using phone and telehealth have been provided by Tāmaki Health’s GPs and nurses since midnight on 25 March through to 29 April from our network of over 30 clinics.

By far the largest ethnic group using virtual consults are Pasifika at around 44 per cent of calls, followed by people of Asian ethnicity at around 26 per cent, Maori at around 16 per cent, and Europeans at just over 10 per cent.

“These figures really break down preconceived stereotypes some had of our high needs patient population, confounding the idea that these groups would not participate in virtual consults,” says Mark Vella, CEO of Total Healthcare. 

Trend evident early on

Mark says the pattern of high acceptance of the service among its 230,000-strong patient base was evident from the first full week of lockdown. Practitioners in the Tāmaki Health network have delivered well over 3000 consultations a week, peaking to nearly 4000 in the third week of April.

“As a result, the success of the service will certainly influence our model of care delivery as we move forward,” Mark says.

As well as the ready access to care for patients, the virtual consults also have the capacity to reduce the strain of waiting room numbers in the future.

“We are hearing from some clinicians that, free from the pressure of knowing there are large numbers of other patients waiting outside the consulting room, they are able to focus better on patient advice and some have felt they have provided a more valuable consultation as a result.” 

Cost is one factor

Mark acknowledges, too, that cost is one factor in the ready uptake as practices have not been charging patients for the virtual consult service. But many of the PHO’s 50 practices operate on a 90 per cent capitation basis anyway, and 28 of them receive the Government’s Very Low-Cost Access (VCLA) funding support for their high-needs patient base.

Under the VLCA scheme and the Community Service Card (CSC) holder subsidies, which Mark helped to negotiate nationally on behalf of PHOs and GP practices, in-clinic medical appointments and care is free to under 18-year-olds, $10 for CSC holders and $15 to $18 for people aged 18 years plus ‒ but only for those who can afford to pay. 

In some of the PHO’s provider’s largest practices, 85 per cent are high-needs patients.

As well, under the capitation structure, practices are reimbursed by Government for patient care according to the total number of patients they have registered which, again, reduces and or removes the fee that needs to be charged. However, Mark has been part of a national negotiation team that has lobbied for the upcoming budget to include ethnicity and deprivation adjusters in the capitation funding formula. 

“We eagerly await the 14th of May when Minister Robinson releases the budget,” Marks says.