Telehealth guidance for practitioners

Registered health practitioners are playing a vital role in treating and containing the novel coronavirus that causes COVID-19. This is an unprecedented situation and we know you are working hard to keep people safe in a demanding and fast-changing environment.

Ahpra and the National Boards have developed the following information which outlines our expectations of how registered health practitioners will use telehealth in the context of the COVID-19 pandemic.

While practitioners may decide to use telehealth for a range of reasons, the Australian Government has recently introduced new temporary Medicare Benefit Scheme (MBS) telehealth items. Information about these new temporary telehealth items can be found on the MBS website.

Download a PDF of the Telehealth guidance for practitioners (107 KB,PDF)

Telehealth is healthcare delivery or related activities that use any form of technology as an alternative to face-to-face consultations. It includes, but is not restricted to, videoconferencing, internet and telephone. It does not refer to the use of technology during a face-to-face consultation.

All registered health practitioners can use telehealth as long as telehealth is safe and clinically appropriate for the health service being provided. These FAQs provide some guidance on what you might consider and what is expected of you as a registered health practitioner, when providing health services using telehealth.

The new temporary MBS telehealth items are available to specified providers of telehealth services for a wide range of consultations.

Telehealth and technology based consultations are increasingly used to improve access to health services, especially in rural and remote areas. Health practitioners currently based overseas who want to keep providing services to their patients in Australia might consider using this technology to do so. 

In terms of registration requirements and the National Board’s regulatory role, if you are registered with your profession’s National Board under the National Registration and Accreditation Scheme and are based overseas, you can still provide telehealth services to patients based in Australia. However, you should check with health services and funders such as Medicare in relation to any other requirement these bodies may have.

You are reminded that National Boards have the same expectations of registered health practitioners, regardless of whether they are providing a patient consult/patient service by telehealth or face to face. These expectations are outlined below.

The National Boards have the same expectations of practitioners using telehealth to provide patient consultations/patient services as they do when practitioners are delivering services face-to-face. When providing telehealth services, the National Boards still expect that:

  • You will practice in accordance with your National Board’s regulatory standards, codes and guidelines, specifically that you will:
    • act in accordance with the standards set out in your professions’ Code of conduct or equivalent including expectations about confidentiality and privacy, informed consent, good care, communication, health records and culturally safe practice. Further information is provided below.
    • ensure you have appropriate professional indemnity insurance (PII) arrangements in place for all aspects of your practice, including telehealth consultations. Your PII provider can advise you about your PII coverage.
  • You are aware of and comply with:
    • state and territory legislative requirements including (but not limited to) authorities that regulate heath records
    • privacy legislation and/or any other relevant privacy requirements
    • when appropriate, the use of government health and prescription monitoring services such as Prescription Shopping Programme, SafeScript, My Health Record, Healthenet, and
    • any other relevant legislation and/or regulatory requirements.

The Code of conduct1 for a health profession is a key part of each National Board’s regulatory framework to protect the public and support the other objectives of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

Your profession’s Code of conduct defines the National Board’s expectations for practitioners’ professional conduct, including the importance of maintaining a high level of professional competence in order to provide the best healthcare. These codes are also intended to let the community know what they can expect from practitioners.

They provide guidance on the National Board’s expectations of what constitutes good practice and includes guidance about:

  • delivering safe and quality care
  • effective communication
  • confidentiality and privacy
  • informed consent
  • health records
  • culturally safe and sensitive practice
  • patients who may have additional needs
  • working collaboratively with other practitioners, and
  • insurance.

It is the Board’s expectation that this guidance would be applicable to practitioners providing telehealth services or traditional face-to-face services.

You have a professional responsibility to be familiar with your profession’s Code of conduct and apply it to your practice, including when using telehealth.


1Each National Board’s Code of conduct is available on the Board’s website, accessible via: www.ahpra.gov.au.
 For medical practitioners, the Medical Board of Australia’s Good Medical Practice: a code of conduct for doctors in Australia.
 For psychologists, the Australian Psychological Society’s Code of Ethics.
 For nurse and midwives, the Nursing and Midwifery Board of Australia’s Code of conduct for Nurses, Code of Conduct for Midwives and Standards of Practice.

You can deliver safe, effective health services via telehealth by adhering to the same principles you apply when providing care during a face-to-face consultation. The list below is not exhaustive but is designed to provide you with some high-level guidance about what you should do to safely and effectively use telehealth.

Using telehealth to advise or treat patients/clients

  • Assess whether telehealth is safe and clinically appropriate for the patient or client, particularly noting the limitations of telehealth, and whether a direct physical examination is necessary to provide good care.

At the beginning of a telehealth consultation

  • Identify yourself and confirm the identity of your patient or client.
  • Provide an explanation to your patient or client of what to expect from a telehealth consultation.
  • Ensure information is provided to clients and patients in a way they understand, and that informed consent is obtained, in particular, in relation to fees, proposed treatment and if you are recording the consultation.
  • Ensure you protect your patient or client’s privacy and their rights to confidentially, particularly if you are working from home.

During a telehealth consultation

  • Ensure you effectively communicate with your patient or client to establish their current condition and past health and medication history. Use qualified language or cultural interpreters where needed.
  • Ensure the standard of care provided in a telehealth consultation meets the same required standards as care provided in a face-to-face consultation.
  • Ensure you maintain clear and accurate health records of the consultation.

Ensure continuity of care

  • Make appropriate arrangements to follow the progress of your patient and inform their general practitioner or other relevant practitioners of the treatment provided, including any medications prescribed.
  • Keep other practitioners informed of the patient or client’s condition and the treatment you have provided when you are sharing the care of the patient.

No specific equipment is required to provide telehealth services. Services can be provided through telephone and widely available video calling apps and software such as Skype, FaceTime, Duo, GoToMeeting and others.

As the MBS website explains, free versions of these applications (i.e. non-commercial versions) may not meet applicable laws for security and privacy. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws.2


2Medicare Benefits Scheme, Temporary Telehealth Bulk-Billed Items for COVID-19, webpage accessed 7 April 2020, www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-TempBB 

The Medical Board of Australia has developed Guidelines for technology-based patient consultations to inform medical practitioners and the community about the Medical Board of Australia’s expectations of medical practitioners who use telehealth.

All state and territory health departments have developed information and resources about telehealth.

The Department of Health’s MBS website has information specific to the new temporary bulk-billing items for COVID-19.

NSW State Insurance Regulatory Authority and Worksafe Victoria have released guidance about the use of telehealth.

You can also seek advice from your professional association, insurer or your employer if you have further questions about the use of telehealth.

These FAQs are designed to support practitioners to use telehealth in response to the COVID-19 pandemic. They will be reviewed and updated as required during this time.

 
 
 
Page reviewed 29/04/2020