The COVID-19 pandemic brought about some big changes around the globe. It has changed the ‘norm’ of doing everything ‘in-person’. Of course, the use of technology was already increasing prior to the COVID-19 pandemic. However, the pandemic has increased our reliance on technology, which is not necessarily a bad thing, as it has led to significant improvements and advancements in particular fields.

An area that has seen significant growth amidst this pandemic is the use of Telehealth – reducing our in-person dealings and consults with doctors for our health concerns. Telehealth is an increasingly popular method of delivering health services, as it increases accessibility to healthcare by phone or video call where physical examinations are not necessary. However, because of the nature of health, it is vital that the level of service is of the same quality so that patient care is not compromised. This requires a lot of effort on the part of the Practice and Practitioner. Consults that used to be face-to-face are easily becoming virtual checkups via Telehealth. Is this the future of medicine?

Of course, being able to see a doctor, psychologist, surgeon or other healthcare providers, without having to leave the home, is incredibly convenient. When unwell, it can also reduce the spread of illness. It also saves time by enabling Australians living in rural and remote areas to consult with their doctor, without having to travel to see them. For practices, it can make it easier to expand their reach and for new patients to engage with the practice.

What factors do Practices and Practitioners need to be considering?

Updated Telehealth Guidelines by the Medical Board of Australia took effect on 1 September 2023. The updated guidelines acknowledge telehealth consultations will continue to be an important feature of health care in Australia, however, should not be considered as a routine substitute for in-person consultations.

When practical, video consultations are preferred over telephone consultations with telehealth generally most appropriate in the context of continuing a clinical relationship with a patient that also involves in-person consultations. A mix of in person and telehealth consultations can provide high quality, accessible, ongoing medical care.

We have compiled a list of 5 important factors to consider when implementing Telehealth.

These are as follows:

1. CONFIDENTIALITY, PRIVACY, & CYBER SECURITY

Confidentiality

Is the patient in a location that will maintain their confidentiality?
Is the consultation space quiet and free from distractions?
Are there other people in the room with them? If yes, is the patient comfortable for those people to be in the room?
Are there adequate policies and procedures in place to deal with sensitive (paper-based) information at individual residences, maintaining client confidentiality?

Privacy

Does our Privacy Policy address telehealth?
Are there security and privacy controls in place to discharge the obligation to take reasonable
steps to protect data?
Do our current policies, procedures and risk management protocols include provisions for securely storing of video recordings, images and teleconferencing in accordance with the provisions of Australian Privacy Principle 11?
Do we have a policy for collection and scanning of mail, sending scripts etc?

Cyber Security

Security of data is paramount consideration in evaluating the means by which telehealth is conducted.

Do we have polices and procedures in place in the event of a Notifiable Data breach?
Do we have an IT Policy & Protocols to deal with cyber security?
Do we have cyber security insurance?

These are just some of the questions that need to be answered when considering telehealth and confidentiality, privacy and cyber security.

2. HARD COPY ISSUES

Normally, prescriptions, certificates, and other sensitive paper-based information are given and handed to patients right after check-ups.

The updated September guidelines emphasise prescribing or providing healthcare for a patient without a real time direct consultation, whether in-person, via video or telephone is not good practice and not supported by the Medical Board. This includes asynchronous requests for medication communicated by text, email, live-chat or online that do not take place in the context of a real-time continuous consultation and are based on the patient completing a health questionnaire, when the practitioner has never spoken with the patient.

However, the Medical Board also recognises that it may be appropriate in certain circumstances for a practitioner to prescribe medication without consultation, but nonetheless they must be able to explain how this was appropriate and necessary for the patient under the circumstances.

Therefore, it is important to ensure that the same standard of care and time applies to a telehealth appointment as it would a typical in person appointment. Consider;

Have we had a real-time doctor-patient conversation?
How are these paper-based documents handed over to patients?
Does the patient have access to the digital script?
Is the patient aware of how to collect or receive referrals, prescriptions, and examination and test results?

3. TECHNOLOGY

Do we have adequate equipment and software suitable for telehealth?
Where possible, do we have access to a professional rather than a personal account?
What arrangements are in place to provide our doctors with access to the software required?
Does the telehealth equipment comply with regulations for electronic storage?
Do we have a backup plan if there is a failure?

4. BILLING METHODS WITH TELEHEALTH

Read and understand the new MBS requirements for telehealth billing.
Have a clear Policy about Medicare and bulk billing.
Consider how full financial consent from the patient about out of pocket costs will be obtained.
How will payment be collected from patients following a telehealth consult?

5. PRACTICE CONSIDERATIONS

Have we considered which services are appropriate to offer through telehealth?
Do our telehealth consultations suit our patients?
Have we considered relationships with other health care providers?
Do our practitioners need training to gain technical expertise?
Do we have a workspace that is appropriate for telehealth?

The factors mentioned above are only a few of the many that must be considered before implementing Telehealth to ensure that patients receive the same quality of service whether they are in-person check-ups or virtual check-ups.

We know how important it is to get Telehealth right. Our Telehealth policy covers how Practitioners should conduct Telehealth Consultations, provides the responsibilities of both the Practice and the Practitioner in providing a Telehealth Consultation to Patients, as well as considerations that should be taken into account when determining whether a Patient is suitable for a Telehealth Consultation based on their individual health needs and requirements. To purchase, click here.

We also have a complimentary Risks of Telehealth Checklist, which you can download here. This Checklist is designed to help you prepare your practice and practitioners for conducting Telehealth Consultations.

If you have any other questions about this topic or our fast-track solution, or anything else, you can contact us here.

Further Information

The Medical Board of Australia’s Telehealth Guidelines can be found here.

Is Telehealth the Future of Medicine in Australia?