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Telehealth is surging in popularity across all tiers of the healthcare system, yet uneven uptake of the model suggests there is scope to strengthen the conditions which enable it to thrive.
Dr Desmond Graham, Chief Medical Officer and Geriatrician for Geriatric Care Australia, believes some healthcare providers remain cautious of the technology, and claims a formal telehealth training pathway may be needed to accelerate uptake.
“The healthcare sector is bound by and conscious of protocols,” he said. “We are used to obeying rules, so it can be unnerving to make big changes to how we deliver care, without clear guidelines to follow.
“For some, it may be mildly off-putting not to have dedicated telehealth training available, while others could have understandable concerns about clinical risk, governance and medico-legal obligations, particularly for complex patients.
“As a sector, we also have a very fixed cultural identity in that, whenever there is any evolution in medicine, it does take a while for it to filter down into common practise, unless of course you have an event like COVID, which has been the catalyst for telehealth uptake so far.”
While Dr Graham believes caution around telehealth is valid, he said much of it is based on misconceptions. Research shows that, for many presentations, it is a safe and effective medium of care, when used appropriately and with clear escalation pathways.
Moreover, for a growing number of people in rural, regional and remote areas, it may be the only medium of care, he highlights.
“We know that some older people are choosing to live outside major cities, in part to relieve cost of living pressures. These are some of our most vulnerable people, from a health perspective, and they are facing added disadvantage, with a lack of in-person services in the places they have chosen to live.
“These places would greatly benefit from telehealth to improve healthcare access. Yet we are finding that many metropolitan services could extend their reach through telehealth.
“The way I see it, just because someone chooses to move up the coast or out West, it shouldn’t mean that, as they enter the more vulnerable stages of their life, that they can’t access healthcare, particularly specialist services.”
As well as concerns around its efficacy, Dr Graham said the under-utilisation of telehealth may reflect a lack of recognition of its need.
Part of the reason, he said, is that metro-dwellers are over-represented in the healthcare workforce, with the majority of training and specialist doctors living and working in areas with a 1 or 2 MMM classification. This indicates they reside within the centre or suburbs of a major city.
“If we have this proportion of our workforce at this classification level, then their scope of practise and the challenges they may have on their radar may be skewed. In comparison, the smaller proportion that provides support to rural, regional and remote areas may have a greater appreciation of the challenges those people face,” he said.
Where to from here?
Dr Graham said a dedicated training pathway that lays out the exact steps towards best practice in telehealth would be valued by industry.
“For instance, in medicine, almost every doctor, irrespective of their subspecialty, follows a famous book by Tally and O’Connor, which talks you through the step by step of how to perform the perfect physical examination. There is no equivalent of this for telehealth – nowhere near it – and I think it’s a void that needs to be filled.
“When we think about the growing demand for telehealth, particularly in areas like geriatrics, there is no standard on how to perform the perfect telehealth consult. And if there’s no framework to refer to, it automatically creates a barrier to practice in that space.”
For change to happen on the ground, however, Dr Graham said training must also be embedded at the organisational level.
“Strengthening telehealth competencies within Geriatric Advanced Training—alongside existing clinical skills—could support consistent practice and confidence.
“At present, most hospital departments don’t really provide telehealth, particularly to rural regional areas, but if it were embedded in their training, this could change rapidly.”
As well as discussing the why’s and how’s of telehealth implementation, the training should address misconceptions around the technology, he recommended.
“There is this idea that we can’t do medical consultations, effectively via telehealth, which I don’t think is correct. Also, to me, when we’re talking offering a lifeline to some of the most vulnerable and isolated people in Australia, perfect should never get in the way.
“The reality is, there are certain things that you can easily do via telehealth. You can take a good history for instance. You’re not going to be able to listen to someone’s chest and hear their breath sounds, but to me, that shouldn’t detract from the benefits. As long as you comment on your inability to do that, and the patient you’re speaking to is aware of the limitations, then it’s no different to any type of medical care you provide.”
Further insight
Sharing more advice on how a telehealth training pathway might look, Dr Graham will present at the upcoming National Telehealth & Virtual Care Conference – one of three to be held concurrently at Connect Virtual Care, held 2-3 April 2026 at the Hilton Sydney.
One pass to Connect Virtual Care gives you access to:
– National Telehealth & Virtual Care Conference
– Hospital in the Home Conference
– AI in Health Regulation, Policy and Standards
Learn more and register your tickets here.
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