Due to the threat of COVID-19, in 2020, Australia has seen a rapid growth in the provision of telehealth services in the health care industry.
What is telehealth?
The Royal Australian College of General Practitioners defines telehealth as “a method of delivering healthcare that involves the use of information and communications technology (ICT) to transmit audio, images and/or data between a patient and a healthcare provider”.
That is, rather than consulting with a patient in person and face-to-face, a medical practitioner provides health care services to the patient via technology-based means such as:
- video consultations;
- phone consultations; and
- the provision of electronic scripts.
Telehealth before COVID-19
Prior to the rise of COVID-19 in Australia, the Medicare Benefits Scheme funding for telehealth services was only available in limited circumstances such as for those:
- living remotely;
- living in aged care facilities;
- receiving specialist-end services provided by a specialist with a Medicare provider number; or
- receiving care from Aboriginal Medical Services or Aboriginal Community Controlled Health Services.
The Government’s response to COVID-19
On 29 March 2020, as a result of the emergence of COVID-19 in Australia, the Australian Government announced that it would expand Medicare-subsidised telehealth services for all Australians, including GP services, until 30 September 2020.
On 18 September 2020, the Government announced that the permitted provision of such services would be extended to 31 March 2021.
These measures have been introduced to assist health care professionals to continue to provide services to those in need while protecting both practitioners and patients from the unnecessary risk of contracting the Coronavirus.
Continuous care requirement
On 10 July 2020, on the recommendation of several organisations such as the Australian Medical Association and the Royal Australian College of General Practitioners, the Minister for Health announced that, from 20 July 2020, telehealth GP providers would need to have an existing and continuous relationship with a patient in order to provide Medicare-subsidised telehealth services. Exemptions to these requirements include patients living in a COVID-19 impacted area, as defined by separate state and territory public health orders.
By ensuring that the practitioner and the patient have an existing relationship, the system aims to ensure that patients continue to receive quality and continuous care from a practitioner who has knowledge of the patient’s medical history and requirements moving forward. That is, it is intended to encourage the practice of good medicine.
For a ‘relationship’ to exist, the patient must have seen the same general practitioner for an in-person consultation in the last 12 months or have seen another general practitioner at the same practice for a face-to-face consultation during the same period.
Risks associated with telehealth services
Whilst many people are benefiting from being able to access telehealth services during the COVID-19 pandemic, there are still several risks and challenges associated with the provision of these types of services.
It should be noted that medical practitioners who are providing telehealth services are still required and expected to act in accordance with the Medical Board of Australia’s Good Medical Practice: A Code of Conduct. Furthermore, on 27 July 2020, the Australian Health Practitioner Regulation Agency (“AHPRA”) and the National Boards published a document entitled ‘Telehealth guidance for practitioners’ which outlines APHRA’s expectations for those practitioners providing telehealth services during COVID-19.
Despite these obligations and expectations in relation to the conduct of medical practitioners providing telehealth services, the following risks make the telehealth sector a closely monitored and somewhat concerning space:
- Professional obligations: it may be difficult for doctors to adhere to their professional obligations, expectations and the industry standards via an online / audio only platform.
- Limited consultation services: the practitioner is not able to perform a physical examination of the patient, which is clinically important in many cases.
- Disruption to continuous care: if it is easier for patients to access telehealth services, they may be more likely to seek assistance from practitioners providing such services rather than their usual doctor.
- Medical history: doctors issuing ‘instant scripts’ or electronic prescriptions may not have access to the patient’s medical history.
Telehealth moving forward
Whilst the Government has not indicated whether the expanded access to the Medicare-subsidised telehealth services will continue after 31 March 2021, due to the risks referred to above, the Government, medical authorities and key stakeholders have, historically, generally favoured traditional doctor-patient face-to-face consultations. The Office of the Federal Minister for Health has, however, made some positive public statements about the potential for a level of Medicare-subsidised telehealth services continuing beyond 31 March 2021.
If you would like to speak to one of our solicitors in relation to the current permitted telehealth activities or any other medical, health or life sciences industry related legal or compliance matter, please contact e Meghan Warren (Principal) on mwarren@burkelawyers.com.au or by contacting our office on +61 3 9822 8588
Insight written by George Hanger
