26 September 2023

Audit checks-in on telehealth

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A performance audit into the Department of Health and Aged Care’s expansion of telehealth services has found the expansion has objects but was not adequately monitored or evaluated.

In his report Expansion of Telehealth Services, Auditor-General Grant Hehir said the Department expanded telehealth services in response to the COVID-19 pandemic to ensure continued access to essential health services and flexible health care.

Mr Hehir said however, there were shortfalls in the governance, risk management and evaluation of the expansion.

“The temporary and permanent expansion of Medicare Benefits Schedule (MBS) telehealth items was informed by largely robust policy advice and planning,” Mr Hehir said.

“The implementation of temporary and permanent telehealth was based on business-as-usual processes for changes to MBS items, and there was no implementation plan for temporary telehealth,” he said.

“There was a high-level implementation plan for the permanent expansion of telehealth, although this did not adequately address evaluation.”

Mr Hehir said Health implemented significant changes to the MBS and in doing so provided largely appropriate support to delivery partners, “however, the telehealth expansion was only partly supported by sound implementation arrangements”.

He said that although the Department conducted risk-based post-payment compliance activities, the governance arrangements for the implementation of temporary telehealth involved inadequate assessment of the implementation and integrity risks.

“Health did not plan for performance monitoring or evaluation of temporary or permanent telehealth,” the Auditor-General said.

“Performance monitoring of the temporary telehealth expansion was limited and lacked measures and targets that could inform judgements about performance, and there was no evaluation that could assist with the design and implementation of potential expansions to telehealth during future emergency conditions,” he said.

“Evaluation of permanent telehealth is developing.”

Mr Hehir made four recommendations related to the governance of MBS changes, risk management and evaluation of the temporary and permanent telehealth expansion.

The Auditor-General’s Report can be accessed at this PS News link and a 76-page pdf version at this link and the audit team was Michael McGillion, Kai Swoboda, Sam Jones, Dr Jennifer Canfield, Bezza Wolba, Alicia Vaughan, Daniel Whyte and Christine Chalmers.

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