The Guidelines: Telehealth consultations with patients (Telehealth Guidelines, Guidelines) will come into effect on 1 September 2023.

The Guidelines set specific obligations practitioners must fulfil when providing telehealth consultation, and outline the circumstances in which telehealth is considered appropriate.

What is 'telehealth'?

'Telehealth' is any form of technology-based medical consultation as an alternative to an in-person consultation. This includes video, internet or telephone consultations, photography, transmitting digital images and/or data and online prescribing.

What is not telehealth?

The Guidelines include a list of health services Ahpra does not consider to be Telehealth (and are therefore not captured by these Guidelines), namely:

• the use of technology during an in-person consultation;
• when an opinion is provided by one doctor to another;
• remote patient monitoring; or
• tele-education.

To whom do the Guidelines apply?

The Guidelines apply to registered medical practitioners.

When is telehealth appropriate?

The Guidelines state that 'telehealth is not appropriate for all medical consultations'. It is the practitioner's duty to determine whether telehealth is appropriate in the patient's particular circumstances. The practitioner is required to have a procedure in place to inform a patient that they may need to be seen in person if the doctor considers a telehealth consultation alone is not appropriate.

Ahpra has confirmed telehealth is generally most appropriate in the context of a continuing clinical relationship with a patient that also involves in person consultations. The Guidelines highlight the value of telehealth, when mixed with in-person care, as a way to facilitate 'high quality, accessible and ongoing care'. The Guidelines specify video consultations are preferable to phone consultations.

Ahpra states that it recognises the importance of telehealth in episodic and emergency care, especially in rural and remote settings. The Guidelines explicitly state that they 'do not' prevent one-off telehealth consultations.

The standard of care for telehealth must be safe and, 'as far as possible' meet the same standard as an in person consultation.

When is telehealth inappropriate?

Ahpra has made it clear that 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 is not supported by the Medical Board. This includes asynchronous requests for medication.

The burden is on the practitioner to demonstrate asynchronous prescribing or provision of care was justified and clinically appropriate in the circumstances.

Having said that, Ahpra recognises it may be appropriate for a patient's usual practitioner (or another practitioner who reviews the patient's records), to prescribe without consultation in certain circumstances.

Telehealth will also be inappropriate where the lack of in-person interaction and/or ability to perform a physical exam will prevent the practitioner from discharging their duty of care to the requisite standard.

Specific obligations on practitioners during a telehealth consultation

At all times a practitioner must comply with Good medical practice: a code of conduct for doctors in Australia (GMP). The Guidelines complement GMP.

The Guidelines include two pages outlining specific requirements medical practitioners must fulfil when providing telehealth consultations (Specific Obligations). These two pages read as a checklist / prompt that practitioners can use prior to, and/or during a telehealth consultation.

Telehealth service providers may wish to print the Specific Obligations and consider how they could be incorporated into existing policies and procedures.

Next steps

Healthcare providers who provide or are proposing to provide telehealth consultations should:

• ensure telehealth consultations are compliant with the Guidelines;
• incorporate the Specific Obligations into existing policies and procedures;
• educate relevant practice staff on the Guidelines and Specific Obligations; and
• continue to comply with other requirements, for example relevant Medicare billing requirements.

If you would like advice about how the Guidelines will impact your business, please contact one of our contacts below.