"At the moment there is no real incentive for a big DHB to see patients by telemedicine, because it doesn't cost them to have them come to the DHB in person. The sending DHB pays for that. It is kind of backwards that way, and we are trying to turn that around, more likely that funding wont' get in the way," says Garrett.
The secret sauce
Garrett warns that while telemedicine involves a lot beyond mere technology, the equipment needs to be world-class in order to enable the transformation of health provision.
"You have to be very careful with the quality of the equipment that you choose. You need to be sure that you have got high quality video conferencing so that picture quality is good, and high definition. You need to make sure that there is no video lag, pixelation or lag. You can't see patients if your video conferencing technology does not work well.
"That means the equipment needs to be good and the network needs to be good. We are mostly good with that between hospitals. Most hospitals are well connected in terms of data speed and capacity. It is not so easy to be sure about that once you get into the community," says Garrett.
When clinical staff move out of the hospital's network they become dependent on the speeds provided by the ISPs and this might not always be adequate, consistent or reliable.
"It would be interesting to see what 4G does. But I suspect that it might also be not adequate or not consistently adequate. We are getting to the point where there are number of networks off the coast. For a while it was just one; now there are three, and more are getting active. We do have a problem where we don't have interoperability between those networks and that is the equivalent of not being able to directly call a Vodafone number from a telecom number.
"We probably need to find a way through that to make sure that we can keep making and building out networks in NZ to continue to enable more advances in telemedicine," states Garrett.
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