Australian digital doctor service Qoctor is moving to solidify its position as a national healthcare provider with plans to expand beyond sick notes and referral letters to provide comprehensive GP services and specialist appointments by the end of 2018.

Primed to issue its 15,000th medical certificate in the next week, Qoctor has been embraced by patients who choose to access sick notes online following a telehealth consultation with a doctor. The company last year also expanded to provide prescriptions and medication delivery nationwide.

But the company’s greatest growth spurt will likely occur when patients are able to book video consultations with Australian GPs to address their wider healthcare needs, including chronic disease management and mental health issues.

The expansion plans will also see the company that was established in 2015 increase its offerings to include appointments via the platform with psychologists, dietitians and physiotherapists, as well as specialist doctors.

“We plan to offer an increased array of services covering a broader range of medical issues, with the ultimate aim of being able to assess practically any health problem online, leading to treatment, further investigation or referral to a specialist as appropriate. We would like to offer comprehensive chronic disease management as well as seamless access to allied health services online,” practising GP and CEO of Qoctor Dr Aifric Boylan told Healthcare IT News Australia.

According to Qoctor, 22,112 hours have been saved by patients using the service who would otherwise have taken time off work, travelled to their GPs’ practices and sat in waiting rooms for their appointments. The company calculates cost benefits to Medicare of $678,086.

“We believe the service has attracted such large numbers because it’s convenient and affordable. It allows busy people to access healthcare at a time that suits them, which is particularly helpful for shift workers. I think it also reflects the reality that people are searching for answers to health issues online and until now the options had been very limited,” Boylan said.

“People have taken to it very well. Our online assessment and treatment services for contraception, erectile dysfunction and sexual health have been the most popular.” 

[Read more: Call for Medicare to catch up, as the momentum of telehealth uptake grows | Online doctor services pose a serious risk to patient safety, GPs claim]

But online GP platforms have attracted criticism from the RACGP, which has claimed they fragment care and provide patients with prescriptions, referrals or medical certificates without sufficient understanding of medical history and social context.

Boylan said the debate is important as there will always be resistance to change.

“Any move away from a long-established way of doing something will attract debate, it’s to be expected, and is a necessary and important conversation to have as online healthcare becomes more commonplace,” she said.

“Some of the issues raised have related to ‘continuity of care’. However, the reality is that many people do not attend the same doctor every time for simple things like contraception, so moving to an online service is no different, and in some ways may improve continuity. Once we accept that large numbers of people expect to access quality healthcare online, the focus shifts to the challenge of making that a reality. That’s our focus.”

The company that began as Dr Sicknote and now employs a team of eight qualified GPs and one pharmacist is tailoring its services to meet the expectations of digitally engaged patients, Boylan said.  

“The reality is that people are already online seeking answers to their health problems and concerns. It’s quite incredible when you look at the numbers of health-related Google searches that are happening every day in Australia. As a quick example, 60,000 people googled the word ‘endometriosis’ last month, 22,000 googled ‘erectile dysfunction’, and 20,000 googled ‘gastro’. The challenge is for healthcare providers to meet people effectively in this online space.”

Telehealth is booming in countries such as the US, where an estimated 1.25 million online patient consultations occurred in 2016, according to the American Telemedicine Association.

Most Australian patients pay out-of-pocket fees for telehealth consultations and calls are growing for changes to the Medicare Benefits Schedule to include online healthcare appointments, with the outlay to be reimbursed by savings throughout the healthcare system.

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