Allied healthThere remains no clear and consistent agreement on what comprises the allied health workforce at either the Commonwealth or State and Territory Government levels. Indeed, the inclusion or otherwise of healthcare professions within allied health remains a matter of debate at practitioner, peak body and payer levels. The 15 professions investigated in this report balances the requirement for comprehensive understanding of the allied health sector against existing knowledge, individual sector size and homogeneity, and the cost of data collection.
Given the complexity of this space, DOHA has specifically requested prioritisation of 15 specific professions within allied health, comprising:
- Aboriginal and Torres Strait Islander health workers
- Dental health professionals
- Exercise physiologists
- Occupational therapists
- Radiographers and sonographers
- Social workers
- Speech pathologists
This report does not investigate professions acknowledged by the Australian Health Workforce Advisory Committee as being outside allied health (e.g. doctors, nurses, peripheral health workers such as dental assistants and diabetes educators, and alternative therapists), those professions covered by an adjacent study (e.g. medical specialists), those professions covered by separate agreements with the Australian Government relating to IT needs and eHealth (e.g. retail pharmacists), and those professions which are relatively small compared to other professions (e.g. othotists, prosthetists, orthoptists, and rehabilitation engineers).
Geographic classificationsOur classification of location corresponds with prior healthcare sector reviews (AHWAC 2006.12), and is based directly on the Australian Standard Geographical Classification (ASGC) as published by the Australian Bureau of Statistics. In response to the limited number of allied health practitioners in remote areas, the ‘Remote’ and ‘Very remote’ categories have been consolidated into a single category, whilst the ASGC ‘Offshore’ classification is considered irrelevant in this instance.
eHealthWe broadly define eHealth as the combined use of electronic communication and technology in healthcare. This definition encompasses four general categories of technology solutions – electronic information sharing, practice management tools, service delivery tools and contribution to health information sources – as detailed in Exhibit 3. While the precise future state of eHealth is difficult to predict, the current landscape and expected lead applications find broad consensus.
EXHIBIT 3 – eHealth solutions currently in use
Since the initial release of the National eHealth Agenda in 2008, the health landscape has evolved significantly. In a number of areas (e.g. diagnostic radiography and sonography), it has evolved more quickly than anticipated. Likewise, technology is evolving so fast (e.g. smart-phones, mobile applications) that it is difficult for policy statements to remain current. Rather than take a static view of eHealth based on the current state, it is necessary to consider future applications, particularly in light of the PCEHR Concept of Operations and the Department’s understanding of the likely or intended role of allied health practitioners downstream. eHealth applications that have gained traction internationally and are likely to become increasingly relevant in Australia are listed in Exhibit 4.
EXHIBIT 4 – Anticipated eHealth solutions
TelehealthFor the purposes of this research, telehealth has been defined more broadly than under the Medicare Benefits Schedule (MBS)3 We define telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. We asked survey respondents and interviewees to consider both clinical elements of the health care system such as remote consultations with patients and other practitioners, and non-clinical elements such as remote training.
ReadinessWe define eHealth readiness across three dimensions:
Infrastructural readiness: to what extent does the practitioner’s external environment and infrastructure support eHealth adoption? For example, does the practitioner have the requisite computer systems and connectivity to use a full spectrum of eHealth solutions, and are suitable systems commonly available?
- Attitudinal readiness: Do practitioners believe that the benefits from adopting and using eHealth solutions outweigh the costs and risks? How willing are they to engage in new technologies?
- Aptitudinal readiness: To what extent does a practitioner have the skills, training and IT support needed to adopt and use eHealth solutions to their full potential?
This three-dimensional approach provides a more robust understanding of the current state of readiness and likely barriers and enablers. It allows an assessment of not only the existing hardware and software used today, but also how it is used and the underlying reasons for usage or lack thereof. It also provides the foundation for understanding the gaps and barriers to eHealth and their root causes (which can range widely from concerns such as over implications for their role, implications of information transparency, or efforts or costs they anticipate relative to benefits or incentives).
Additionally, we consider eHealth readiness within the context of expected use, which often varies considerably based on the nature of a practitioner’s work (e.g. specialty, geographic location, practice setting, and type of patients).
2 Australian Health Workforce Advisory Committee (2004), The Australian Allied Health Workforce - An Overview of Workforce Planning Issues, AHWAC Report 2006.1, Sydney
3 MBS Telehealth rebates are limited to remote consultations online or via video conference with rural, regional and outer metropolitan patients.