This is the first time the Medical Board has published updated telehealth guidance since 2013.
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, remote patient monitoring and online prescribing.
The Draft Guidelines
Consolidating existing obligations
For the most part, the Draft Guidelines consolidate existing obligations. There is a checklist of things practitioners 'need to do' when providing telehealth consultations, as well as a summary of standards the Board expects all medical practitioners to meet when performing telehealth activities, for instance:
- The Board expects all medical practitioners to follow Good Medical Practice: A Code of Conduct for Doctors in Australia (AHPRA, 2020) (Code of Conduct) regardless of the circumstances in which they consult a patient;
- The standard of care provided in a telehealth consultation must be safe, and as far as possible, meet the same standards of care provided in a face-to-face consultation; and
- Practitioners must ensure, among other things, that the telehealth method protects the patient's confidentiality, is culturally appropriate, facilitates clear communication, and enables the practitioner to obtain appropriate informed patient consent.
The Draft Guidelines make it clear that telehealth should not be a 'substitute' for in-person care, and the practitioner should 'continually' assess the appropriateness of telehealth and have 'arrangements' in place for in person consultation 'where necessary'. The introduction to the Draft Guidelines confirms that telehealth is generally most appropriate in the context of an ongoing clinical relationship that also involves face-to-face consultations.
Having said that, the Draft Guidelines specifically acknowledge the importance of telehealth to ensure access to medical care in regional and remote setting; in particular access to specialist care.
The Medical Board will not support the delivery of some services via telehealth
Some of the statements in the Draft Guidelines are new. Most notably, the Draft Guidelines explicitly state the Board will 'not support' practitioners who prescribe or provide healthcare to patients 'whom the practitioner has never consulted, whether face-to-face, via video or telephone'. This statement appears to be directed at online health businesses and is consistent with the sections 3.1 and 3.2 of the Code of Conduct.
The Draft Guidelines explicitly state that the Board will 'not support' requests for medication communicated by text, email or online that 'do not take place in real-time and are based on the patient completing a health questionnaire but where the practitioner has never spoken with the patient'. Practitioners who choose to consult patients via telehealth in those circumstances will be required to 'explain' how the prescribing was appropriate and necessary.
These comments, if the Draft Guidelines are approved, may limit the services some medical practitioners can provide via telehealth.
Any medical businesses and service providers that rely on telehealth or use telehealth as part of the service delivery should review the Draft Guidelines in detail. The consultation period will close on 17 February 2023.
Please contact us for a confidential discussion if you would like advice about how the Draft Guidelines might impact your heath business.