With telehealth, or ‘healthcare at a distance’, gaining ground due to technological advancements and many practices offering telehealth consultations, practice managers need to ensure their practice complies with Medicare and documentation requirements.
What is telehealth?
Telehealth is known as the transmission of health
information and images via a range of telecommunication technologies. MBS
rebates for telehealth video consultations commenced in July 2011. Video
consultations are an alternative to face-to-face consultations and may be of
particular benefit for patients and practitioners located in rural and remote
telehealth eligible areas.
Medicare now provides incentives and rebates
for medical practitioners to engage with patients via video consultations in
specific circumstances. Patients must be located in rural and remote areas, or
in eligible aged care facilities or Aboriginal medical services throughout
Australia. Rebates are also available for clinical services provided by a
health professional who is present with the patient during the video
Practices may investigate the opportunity to utilise
telehealth technology in certain situations outside of those circumstances
covered by the MBS rebates. In these circumstances, practices are not bound by
the guidelines defined by Medicare but will be required to meet ethical and
professional standards. If practices are going to utilise telehealth they
should ensure that they adopt appropriate protocols to ensure that they will be
covered by their medical and practice insurance.
Medicare rebates are
available for video consultations where a patient consults with a specialist in
specific circumstances and if clinically appropriate. There must be both a
video and an audio link.
A specialist must be satisfied that it is
clinically appropriate to provide a video consultation to a patient. Advice
from the referring practitioner may assist in this decision and the referring
practitioner and specialist should be satisfied that adequate care can be
given in the absence of an examination being performed by a specialist. This
will need to be determined on a patient-by-patient basis as well as a
Medicare rebates for specialist
consultations are available across the full range of medical specialties. There
may be a general practitioner, midwife, nurse practitioner, Aboriginal health
worker or practice nurse providing services on behalf of a general
practitioner, present to provide “patient-end” services. The practitioner at
the patient end, if any, may conduct parts of the examination under direction
from the specialist.
General practitioners providing the patient-end
services are ordinarily entitled to a Medicare rebate. However, general
practitioners who provide direct telehealth consultations with patients cannot
claim the Medicare rebate but can charge privately.
All users and practitioners should
keep full notes of their consults with patients as though the patient was
sitting in the room with them. Practitioners at the patient-end must keep
records of the consultations that specifically document:
that the service was performed by video conference
2. the time taken to
conduct the consultation
3. the people who participated in the
Avant’s Practitioner Indemnity Insurance Policy
Avant’s Practitioner Indemnity
Insurance Policy provides cover for claims made against a practitioner by a
patient or a patient’s family in relation to the practitioner providing
telehealth. Telehealth is defined in the policy as “Healthcare or Unpaid
Healthcare to, or in respect of a patient who is not in the same place, that
uses any form of technology, to enable it to be provided, including
video-conferencing, internet and telephone”. This cover excludes claims
that arise as a result of telehealth provided to, or in respect of, a patient
outside Australia or claims that involve proceedings brought overseas. Cover
is otherwise subject to the terms, conditions and exclusions of the
There are many other issues to be aware of when undertaking
telehealth consultations, including follow-up of patients, technology issues,
security and privacy of information, consent and communication.
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