Speaker's Highlight

• Don Sin University of British Columbia, St. Paul Hospital (Canada)
  Kenneth R. Chapman Toronto General Hospital Research Institute (Canada)
• Parameswaran Nair McMaster University (Canada)
  Carolyn Calfee UCSF (U.S.A.)
• Gregory P. Downey University of Colorado School of Medicine (U.S.A.)
  David A. Schwartz University of Colorado School of Medicine (U.S.A.)
• Neil Schluger Tuberculosis Control Branch, California Department of Public Health (U.S.A.)
  Nick Kim Critical Care & Sleep Medicine, University of California San Diego (U.S.A.)
• Nicola Hananiah Baylor College of Medicine (U.S.A.)
  Jae-Joon Yim Seoul National University College of Medicine (Republic of Korea)
• Koichiro Asano Tokai University School of Medicine (Japan)
  Diahn-Warng Perng Taipei Veterans General Hospital (Taiwan)
• Konstantinos Kostikas University of Ioannina (Greece)
  Karin Klooster University Medical Center Groningen (Kingdom of the Netherlands)

• Telemedicine And The Future Of Respiratory Care In Australia

  Telemedicine has become an important part of respiratory disease management, particularly for people who need regular monitoring rather than repeated hospital visits. Video consultations, remote devices and secure digital records can connect patients with general practitioners, respiratory physicians, nurses and allied health professionals across considerable distances.

  For Australians living with asthma, chronic obstructive pulmonary disease (COPD), sleep apnoea or interstitial lung disease, virtual care can make specialist support easier to access. This is especially relevant outside Sydney, Melbourne, Brisbane and other major centres, where travelling to a respiratory clinic may involve taking time off work or driving several hours.

  Telemedicine does not replace every examination or diagnostic test. Its value lies in combining remote consultations with face-to-face assessment, home monitoring and coordinated clinical decisions. When used carefully, this model can support earlier intervention, improve continuity of care and help patients manage symptoms in their daily environments.

  Access To Respiratory Specialists

  Australia’s geography creates a strong case for telehealth. Patients in regional Queensland, Western Australia, the Northern Territory and rural New South Wales may have limited access to respiratory physicians, pulmonary rehabilitation programs or specialist nurses. A video appointment can reduce travel burdens while allowing local GPs and hospitals to remain involved.

  Telemedicine is also useful for follow-up appointments after a diagnosis or hospital admission. A clinician can review breathlessness, cough, medication use and exacerbation history without requiring every patient to attend a metropolitan clinic. For people with mobility limitations or severe COPD, avoiding an unnecessary journey may reduce fatigue and exposure to respiratory infections.

  Access still depends on reliable technology and suitable clinical services. Some remote communities face unstable internet connections, limited private space for consultations or a shortage of local staff who can assist with examinations. Telehealth works best when patients can choose between video and telephone care and when virtual appointments are linked to a clear local care pathway.

  Remote Monitoring And Early Warning

  Connected devices can provide useful information between consultations. Home pulse oximeters, spirometers, smart inhaler systems and continuous positive airway pressure (CPAP) data may help clinicians identify changes in respiratory status. For a patient with asthma, symptom diaries and peak-flow readings can reveal a deteriorating pattern before it becomes an emergency.

  Remote monitoring must be interpreted in context. A single oxygen saturation reading can be affected by cold hands, movement, device quality or incorrect placement. Spirometry performed at home may also be less reliable than testing conducted by trained staff. Digital measurements should support clinical judgement rather than trigger automatic treatment changes without professional review.

  Clear escalation plans are essential. Patients should know which symptoms require a routine appointment, urgent GP review or emergency care. Severe breathlessness, blue lips, confusion or rapidly worsening symptoms require immediate medical attention, regardless of whether a telehealth service is available.

  Supporting Asthma And COPD Self-Management

  Virtual consultations can reinforce practical skills that are often lost after a clinic visit. Nurses and pharmacists can check inhaler technique by video, review written asthma action plans and discuss adherence without making patients wait for their next in-person appointment. This is valuable because incorrect inhaler technique can reduce the benefit of an otherwise appropriate medicine.

  For COPD, telemedicine may support smoking cessation, pulmonary rehabilitation education, breathing exercises and plans for managing flare-ups. Digital coaching can help patients recognise increased sputum, wheeze or reduced exercise tolerance. Family members or carers can join a consultation when the patient agrees, helping them understand warning signs and medication routines.

  Australian clinicians also need to consider seasonal and environmental triggers. Bushfire smoke can worsen asthma and COPD, while pollen, dust and urban air pollution may affect people in cities such as Melbourne and Sydney. Remote reviews can help patients adjust their action plans around poor air-quality days, provided medication changes remain consistent with an authorised clinical plan.

  Integrating Telehealth With The Australian System

  Medicare telehealth has expanded access to phone and video consultations, although eligibility requirements, item numbers and billing arrangements can change. Practices need to explain any out-of-pocket costs before an appointment. Some patients may also use private health services, employer-supported programs or hospital-based virtual clinics.

  Digital information should fit into existing Australian healthcare systems. With appropriate consent and privacy safeguards, relevant notes, test results and medication information can be shared through clinical software and My Health Record. Good information exchange reduces duplication and helps a GP, respiratory specialist and pharmacist work from the same treatment history.

  The local market includes metropolitan specialist networks, regional hospitals, community pharmacies and technology providers offering remote monitoring platforms. Services should be assessed for clinical governance, data security, accessibility and interoperability rather than selected solely for convenience. A platform that cannot exchange information with existing practice systems may create extra administrative work.

  Equity, Privacy And Cultural Safety

  Telemedicine can improve equity, but it can also widen gaps. Older adults may need help using video platforms, while people with limited English proficiency may require an accredited interpreter. Patients experiencing financial hardship may lack suitable devices, data or a quiet room for a private consultation. Telephone appointments remain important for this reason, even when video is preferred.

  Culturally safe care is particularly important when working with Aboriginal and Torres Strait Islander communities. Services should involve local health workers where appropriate, respect community preferences and avoid assuming that a metropolitan model will suit every location. In remote areas, telehealth may be most effective when supported by an Aboriginal Community Controlled Health Organisation or local clinical team.

  Privacy also matters in respiratory care because consultations may involve smoking history, occupational exposures and disability. Clinicians should confirm the patient’s location, identity and immediate safety at the beginning of a remote appointment. Patients should be told how recordings, device data and clinical notes are stored and who can access them.

  Measuring Better Respiratory Outcomes

  The success of telemedicine should be measured through health outcomes, not appointment numbers alone. Useful indicators include hospital admissions, emergency presentations, exacerbation frequency, medication adherence, inhaler technique, pulmonary rehabilitation participation and patient-reported quality of life.

  Services should also track access across different groups. A program may appear successful while excluding people in remote areas, patients with low digital confidence or those who need interpreters. Comparing video, telephone and face-to-face outcomes can show which patients benefit from each format.

  A blended model is likely to be the most practical approach for Australia. Routine reviews, education and device-data assessment can often occur remotely, while new diagnoses, abnormal findings, lung function testing and complex deterioration may require in-person care. Regular evaluation allows services to refine appointment types without treating telemedicine as a universal replacement.

  Telemedicine is becoming a valuable component of respiratory medicine, particularly when it connects patients with clinicians, local services and reliable self-management support. Its strongest role is as part of coordinated care that respects clinical limits, protects privacy and responds to Australia’s geographic and social diversity.

  For a respiratory service or general practice, the concrete next step is to map which follow-up appointments can safely move online and pair each one with an escalation pathway for examination, testing or urgent review.

  Richard Russell Nuffield Department of Clinical Medicine, University of Oxford (United Kingdom)
• Mona Bafadhel King’s College London (United Kingdom)
  David Jackson Guy’s and St Thomas’ Hospital, King’s College London (United Kingdom)
• James Chalmers University of Dundee (United Kingdom)
  David Price University of Aberdeen (United Kingdom)