Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

What should primary care look like after the COVID-19 pandemic?

Stephen Duckett
+ Author Affiliations
- Author Affiliations

Health Program, Grattan Institute, 8 Malvina Place, Carlton, Vic. 3053, Australia, and Department of General Practice, The University of Melbourne, Parkville, Vic. 3010, Australia. Email: stephen.duckett@grattan.edu.au

Australian Journal of Primary Health 26(3) 207-211 https://doi.org/10.1071/PY20095
Submitted: 27 April 2020  Accepted: 28 April 2020   Published: 27 May 2020

Journal Compilation © La Trobe University 2020 Open Access CC BY

Abstract

The response to COVID-19 transformed primary care: new telehealth items were added to the Medicare Benefits Schedule, and their use quickly escalated, general practices and community health centres developed new ways of working and patients embraced the changes. As new coronavirus infections plummet and governments contemplate lifting spatial distancing restrictions, attention should turn to the transition out of pandemic mode. Some good things happened during the pandemic, including the rapid introduction of the new telehealth items. The post-pandemic health system should learn from the COVID-19 changes and create a new normal.

Additional keywords: delivery of health care, models, organisation.


References

Auditor General of Victoria (2018) Community health program. Independent assurance report to Parliament 2017–18. (Victorian Auditor-General’s Office: Melbourne, Vic., Australia) Available at https://www.audit.vic.gov.au/sites/default/files/2018-06/20180606-Community-Health_0.pdf [Verified 30 April 2020]

Bonciani M, Schäfer W, Barsanti S, Heinemann S, Groenewegen PP (2018) The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries. BMC Health Services Research 18, 132
The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries.Crossref | GoogleScholarGoogle Scholar | 29466980PubMed |

Boxall A-M, Gillespie JA (2013) ‘Making Medicare: the politics of universal health care in Australia.’ (NewSouth Publishing: Sydney, NSW, Australia)

Bradford NK, Caffery LJ, Smith AC (2016) Telehealth services in rural and remote Australia: a systematic review of models of care and factors influencing success and sustainability. Rural and Remote Health 16, 3808

Community Health Taskforce (2019) Community health taskforce report to government. (Department of Health and Human Services: Melbourne, Vic., Australia) Available at https://www2.health.vic.gov.au/about/publications/researchandreports/community-health-taskforce-report [Verified 30 April 2020]

DeNicola N, Grossman D, Marko K, Sonalkar S, Butler Tobah YS, Ganju N, Witkop CT, Henderson JT, Butler JL, Lowery C (2020) Telehealth interventions to improve obstetric and gynecologic health outcomes: a systematic review. Obstetrics and Gynecology 135, 371–382.

Duckett S (2017) The effect of red tape on pharmacy rules. Grattan Institute submission to the Senate Select Committee on Red Tape. Grattan Institute, Melbourne, Vic., Australia.

Duckett S, Breadon P, Ginnivan L (2013) Access all areas: new solutions for GP shortages in rural Australia. Grattan Institute, Melbourne, Vic., Australia.

Durham P (2019) Enrolment scheme extended to Indigenous patients over 50. Medical Republic. 20 December. Available at http://medicalrepublic.com.au/enrolment-scheme-extended-to-indigenous-patients-over-50/24606 [Verified 30 April 2020]

Eizenberg P (2009) The general practice experience of the swine flu epidemic in Victoria – lessons from the front line. The Medical Journal of Australia 191, 151–153.
The general practice experience of the swine flu epidemic in Victoria – lessons from the front line.Crossref | GoogleScholarGoogle Scholar | 19645644PubMed |

Erny-Albrecht K, Bywood PT (2016) Corporatisation of general practice – impact and implications. No. 0995391602. (Primary Health Care Research & Information Service: Adelaide, SA, Australia) Available at https://dspace.flinders.edu.au/xmlui/handle/2328/38389 [Verified 30 April 2020]

Faux M, Wardle J, Adams J (2019) Medicare billing, law and practice: complex, incomprehensible and beginning to unravel. Journal of Law and Medicine 27, 66–93.

Ferguson J, Craig EA, Dounavi K (2019) Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: a systematic review. Journal of Autism and Developmental Disorders 49, 582–616.
Telehealth as a model for providing behaviour analytic interventions to individuals with autism spectrum disorder: a systematic review.Crossref | GoogleScholarGoogle Scholar | 30155578PubMed |

Gillespie JA (1991) ‘The price of health: Australian governments and medical politics 1910–1960.’ (Cambridge University Press: Cambridge, UK)

Grattan M (2019) Morrison government funds ‘pop up’ testing clinics and tele-consultations in $2.4 billion COVID-19 health package. The Conversation 10 March. Available at https://theconversation.com/morrison-government-funds-pop-up-testing-clinics-and-tele-consultations-in-2-4-billion-covid-19-health-package-133368 [Verified 30 April 2020]

Iacobucci G (2020) Primary care networks: NHS England under pressure to rein in its ambitions. BMJ (Clinical Research Ed.) 368, m230
Primary care networks: NHS England under pressure to rein in its ambitions.Crossref | GoogleScholarGoogle Scholar |

Jang-Jaccard J, Nepal S, Alem L, Li J (2014) Barriers for delivering telehealth in rural Australia: a review based on Australian trials and studies. Telemedicine Journal and e-Health 20, 496–504.
Barriers for delivering telehealth in rural Australia: a review based on Australian trials and studies.Crossref | GoogleScholarGoogle Scholar | 24801522PubMed |

Jesson JK, Wilson KA (2003) One-stop health centres: what co-location means for pharmacy. Health & Place 9, 253–261.
One-stop health centres: what co-location means for pharmacy.Crossref | GoogleScholarGoogle Scholar |

Jin K, Khonsari S, Gallagher R, Gallagher P, Clark AM, Freedman B, Briffa T, Bauman A, Redfern J, Neubeck L (2019) Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing 18, 260–271.
Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 30667278PubMed |

Keely EJ, Archibald D, Tuot DS, Lochnan H, Liddy C (2017) Unique educational opportunities for PCPs and specialists arising from electronic consultation services. Academic Medicine 92, 45–51.
Unique educational opportunities for PCPs and specialists arising from electronic consultation services.Crossref | GoogleScholarGoogle Scholar | 28030423PubMed |

Knaus C, McGowan M (2020) Australia’s small medical practices on brink of collapse amid coronavirus. The Guardian 9 April. Available at https://www.theguardian.com/world/2020/apr/09/australias-small-medical-practices-on-brink-of-collapse-amid-coronavirus [Verified 30 April 2020]

Lane R, Russell G, Bardoel EA, Advocat J, Zwar N, Davies PGP, Harris MF (2017) When colocation is not enough: a case study of general practitioner super clinics in Australia. Australian Journal of Primary Health 23, 107–113.
When colocation is not enough: a case study of general practitioner super clinics in Australia.Crossref | GoogleScholarGoogle Scholar | 28442054PubMed |

Lawn S, Lloyd A, King A, Sweet L, Gum L (2014) Integration of primary health services: being put together does not mean they will work together. BMC Research Notes 7, 66
Integration of primary health services: being put together does not mean they will work together.Crossref | GoogleScholarGoogle Scholar | 24479605PubMed |

McFarland S, Coufopolous A, Lycett D (2019) The effect of telehealth versus usual care for home-care patients with long-term conditions: a systematic review, meta-analysis and qualitative synthesis. Journal of Telemedicine and Telecare
The effect of telehealth versus usual care for home-care patients with long-term conditions: a systematic review, meta-analysis and qualitative synthesis.Crossref | GoogleScholarGoogle Scholar | 31394973PubMed |

Memon AR, Kinder T (2017) Co-location as a catalyst for service innovation: a study of Scottish health and social care. Public Management Review 19, 381–405.
Co-location as a catalyst for service innovation: a study of Scottish health and social care.Crossref | GoogleScholarGoogle Scholar |

Nataraj J, Stempien J, Netherton S, Wahba MY, Oyedokun TO (2019) Emergency department referrals from a provincial medical call centre: is it more than just 1-800-go-to-emerg? CJEM 22, 241–244.

Oliver-Baxter J (2015) Blended funding models in primary health care. PHCRIS Research Roundup 43, 1–2.

Outcome Health (2020) COVID-19 – a predictive impact model for the healthcare sector. Outcome Health, Melbourne, Vic., Australia.

Rawstorn JC, Gant N, Direito A, Beckmann C, Maddison R (2016) Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis. Heart (British Cardiac Society) 102, 1183–1192.
Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |

Razai MS, Doerholt K, Ladhani S, Oakeshott P (2020) Coronavirus disease 2019 (COVID-19): a guide for UK GPs. BMJ 368, m800
Coronavirus disease 2019 (COVID-19): a guide for UK GPs.Crossref | GoogleScholarGoogle Scholar | 32144127PubMed |

Reinhardt U (2012) Divide et impera: protecting the growth of health care incomes (costs). Health Economics 21, 41–54.
Divide et impera: protecting the growth of health care incomes (costs).Crossref | GoogleScholarGoogle Scholar | 22147628PubMed |

Royal Australian College of General Practitioners (RACGP) (2017) On demand telehealth services. RACGP, Melbourne, Vic., Australia. Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/On-demand-telehealth-services.pdf [Verified 30 April 2020]

Rumball-Smith J, Wodchis WP, Koné A, Kenealy T, Barnsley J, Ashton T (2014) Under the same roof: co-location of practitioners within primary care is associated with specialized chronic care management. BMC Family Practice 15, 149
Under the same roof: co-location of practitioners within primary care is associated with specialized chronic care management.Crossref | GoogleScholarGoogle Scholar | 25183554PubMed |

Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T (2013) In search of joy in practice: a report of 23 high-functioning primary care practices. Annals of Family Medicine 11, 272–278.
In search of joy in practice: a report of 23 high-functioning primary care practices.Crossref | GoogleScholarGoogle Scholar | 23690328PubMed |

Sprague L (2014) Telehealth: into the mainstream? National Health Policy Forum, Washington DC, USA.

Suchowersky A, Suchowersky O, Duckett S (2012) Can Alberta’s primary care networks provide any lessons for Medicare Locals? The Medical Journal of Australia 196, 27–28.
Can Alberta’s primary care networks provide any lessons for Medicare Locals?Crossref | GoogleScholarGoogle Scholar | 22256923PubMed |

Swerissen H, Duckett S, Moran G (2018) ‘Mapping primary care in Australia.’ (Grattan Institute: Melbourne, Vic., Australia)

Tanne JH, Hayasaki E, Zastrow M, Pulla P, Smith P, Rada AG (2020) COVID-19: how doctors and healthcare systems are tackling coronavirus worldwide. BMJ (Clinical Research Ed.) 368, m1090
COVID-19: how doctors and healthcare systems are tackling coronavirus worldwide.Crossref | GoogleScholarGoogle Scholar |

Totten AM, Womack DM, Eden KB, McDonagh MS, Griffin JC, Grusing S, Hersh WR (2016) ‘Telehealth: mapping the evidence for patient outcomes from systematic reviews.’ (Agency for Healthcare Research and Quality: Rockville, MD, USA)

van Gool K, Haas M, Viney R (2002) From flying doctor to virtual doctor: an economic perspective on Australia’s telemedicine experience. Journal of Telemedicine and Telecare 8, 249–254.
From flying doctor to virtual doctor: an economic perspective on Australia’s telemedicine experience.Crossref | GoogleScholarGoogle Scholar | 12396851PubMed |

Viney R, Haas M (1998) Funding arrangements for telehealth: encouraging efficiency rather than proliferation. Australian Health Review 21, 34–48.
Funding arrangements for telehealth: encouraging efficiency rather than proliferation.Crossref | GoogleScholarGoogle Scholar | 10185691PubMed |

Wade V, Soar J, Gray L (2014) Uptake of telehealth services funded by Medicare in Australia. Australian Health Review 38, 528–532.
Uptake of telehealth services funded by Medicare in Australia.Crossref | GoogleScholarGoogle Scholar | 25219655PubMed |

Wells R (1976) Telemedicine: explorations in the use of telecommunications in health care. The Medical Journal of Australia 1, 128
Telemedicine: explorations in the use of telecommunications in health care.Crossref | GoogleScholarGoogle Scholar |

Woodley M 2020) Dire PPE shortage affecting morale: study. newsGP 24 April. Available at https://www1.racgp.org.au/newsgp/clinical/dire-ppe-shortage-affecting-morale-study [Verified 30 April 2020]

Yellowlees P (2001) An analysis of why telehealth systems in Australia have not always succeeded. Journal of Telemedicine and Telecare 7, 29–31.
An analysis of why telehealth systems in Australia have not always succeeded.Crossref | GoogleScholarGoogle Scholar | 11747652PubMed |