GP video consultations a success in residential aged care

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A video consultation pilot program connecting aged care residents with their general practitioner is being held in South Australia’s Barossa Valley.

The Better Health Care Connections: Aged Care Coordination program, known as Silver Connections, being conducted by the Barossa general practitioners (GPs) and local residential aged care facilities (RACF), is improving timeliness of care and reducing after-hours calls and hospital transfers.

Country South Australia Primary Health Network is one of nine organisations funded by the Australian Government from 2013 to trial GPs conducting video consultations with aged care residents.

Silver Connections aims to improve patient care and support older people with complex health needs by coordinating treatment and improving access to multidisciplinary care.

“Silver Connections is reducing frustration between residential aged care facility staff and GPs and meeting residents’ care needs in a timely manner,” said Country SA PHN, Nurse Consultant, Tracy Maynard.

“Our research shows that approximately 30 per cent of video consultations have prevented hospital admissions and transfers to emergency departments.”

Video consultations have proved particularly useful for residents with functional limitations. Importantly, they enable all aged residents to have their medical consultations in comfortable, familiar surroundings.

A registered nurse sits in on all consultations to help and ask any additional questions. This assists residential aged care facility nursing staff to be directly familiar with the residents’ medical needs. Family members are also invited to be present.

The video consultations follow the same privacy and confidentiality agreements as any medical appointment. All medical records are confidential and no consultations are recorded.

During the Silver Connections trial there have been approximately 900 video consultations from nearly 30 Barossa GPs across five general practices to four local RACFs with nearly 200 beds. The research indicates that the trend is for the number of video consultations to increase to 30 to 40 per month.

“Country SA PHN is very happy to be a part of the Silver Connections program. Helping rural aged care facility residents receive timely medical advice in their own surroundings provides great benefits to the residents and streamlines the process for rural GPs,” said Country SA PHN, CEO, Kim Hosking.

“This is particularly apt in many areas of regional South Australia where GPs have large distances to travel.”

Currently, Medicare billing supports telehealth video consultations for specialists and consultant physicians only. GPs are funded via Medicare only for face-to-face visits at aged care facilities, not video consultation.

Desktop computers and iPads, connected via the Cisco Jabber program, are being used to support Silver Connections video consultations. Residential aged care facilities are funded to participate and GPs are funded per consultation with the amount based on the duration of the consultation.

Prior to the Silver Connections program advice on a resident’s health would have been via a telephone conversation between the nurse and GP, without the resident’s input. Giving residents and their families the opportunity to be directly involved in their care is one of the key advantages of this program.

As one RACF nurse recounts:

“Thank goodness we have access to video consultations. If a resident wakes one morning with a medical condition that needed assessing, but the monthly GP visit to the RACF has occurred the day before, the resident will be able to be medically reviewed today, antibiotics commenced, the GP remunerated for their time and most importantly the resident can be on the road to recovery as soon as possible.”

The Silver Connections trial concludes in June this year and will be followed by an external evaluation.

Silver Connection’s success clearly demonstrates a need for telehealth funding by Medicare to be extended to include GP’s. This would allow the program to continue to improve timeliness of care; reduce after-hours calls and hospital transfers and, most importantly, put aged care residents at the centre of their own care.

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