ACC telehealth appointments soar during lockdown

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eHealthNews.nz editor Rebecca McBeth

Half of all ACC-funded Cost of Treatment (CoTR) consultations were done via telehealth during New Zealand’s national lockdown.

ACC enabled telehealth for 11 new providers in response to Covid-19; physiotherapists, GPs, nurses, nurse practitioners, medical specialists, occupational therapists, speech and language therapists, chiropractors, osteopaths, podiatrists, and dentists.

The corporation increased the number of contracts enabled for telehealth from 18 pre-Covid to 34 under alert levels two, three and four and it is now, “exploring options for the permanent implementation of telehealth solutions for appropriate services”.
 
This led to a massive spike in use with around 50 percent of all CoTR consultations conducted via telehealth during the national alert levels three and four, compared to around one percent at national alert level one. 

Ministry of Health advice was for healthcare providers to use virtual, non-contact consultations where possible and particularly during alert levels three and four.

Telehealth use increased again during Auckland’s recent shift to alert level three when it was used for 47 percent of all CoTR consultations in Auckland.

Around 70 percent of providers bill under the CoTR regulations.

John Robson, ACC chief clinical officer, says the organisation is adding telehealth codes to specific services to enable greater visibility of uptake of virtual services and that telehealth “has a role to play in the ongoing delivery of ACC services. 

“We have sought advice from professional bodies and are exploring options for the permanent implementation of telehealth solutions for appropriate services, so patients can engage with providers in the most convenient and effective way to support their recovery goals.” 

Sandra Kirby, chief executive Physiotherapy NZ, says physios had been using telehealth for some appointments prior to Covid, but ACC did not fund these as equivalent to face-to-face appointments and providers billing under CoTR did not qualify. 

When it became the recommended method of engagement under lockdown, use soared and funding increased to the same level as in-person treatment.

She says physios have been coming up with creative ways of delivering care virtually,  including using assistants to demonstrate via video how to splint or strap an injury to a client with a helper at home.

“Our position is that telehealth remains a viable option for many people and a preferable option for some groups in some conditions,” she says. 

“A telehealth consultation has the same value as a face-to-face consultation and it should be continued.”

GP at Island Bay Medical Centre Richard Medlicott says ACC’s decision to fund telehealth appointments for GPs was “invaluable” and he would like it to be made permanent.

He says most of a consultation is in the history and the agreed management plan and often you can do this without examination, or video may give enough information.

NZNO professional nursing advisor Catherine Lambe says telehealth is particularly useful for ACC patients with mobility issues. 

She says funding telehealth appointments also helps with access issues as nurses often deliver care to youth and people who live in remote areas. 
 
Robson says telehealth was new to some professions so ACC facilitated professional bodies to create guidelines for providers who had not delivered telehealth consultations before. 

At alert level one, some services which may be more suitable to be delivered in-person, are being reviewed as to whether telehealth is appropriate for non-emergency circumstances.