Telehealth guidance for practitioners

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. Not all healthcare services are appropriate for telehealth.

All registered health practitioners can use telehealth as long as telehealth is safe and clinically appropriate for the health service being provided and suitable for the patient or client.

These FAQs outline what Ahpra and the National Boards expect of you as a registered health practitioner when providing health services using telehealth. It explains how the Boards’ regulatory guidance such as Codes of Conduct, applies to telehealth and where more information and resources are available.

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, Ahpra and the National Boards consider that you can still provide telehealth services to patients based in Australia. However, you should check with the regulatory authority for your profession in the jurisdiction you intend to practise and with Australian 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 and digital image prescriptions
  • 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, My Health Record, Healthenet, Real Time Prescription Monitoring platforms 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
• professional boundaries
• patients who may have additional needs
• working collaboratively with other practitioners
• practising within your scope of practice, 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.

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 (and regularly re-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.
• Ensure that you do not attempt to provide a service which puts patient or client health or safety at risk.
• If, because of the limits of technology, you are unable to provide a service to the same standard as an in-person consultation then you must advise the patient or client of this. 

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 you patient or client in a way they understand, and that informed consent is obtained, in particular, in relation to fees, proposed treatment, sharing of information with others in their care team 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.
• Use strategies and evidence-informed practices to reflect the standard of care expected in a face-to-face consultation, as far as possible.
• 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 or client and, with the consent of the patient or client, inform other or other relevant health practitioners of the treatment provided, including any medications prescribed.
• When appropriate, 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.
• Where direct physical examination is required to continue providing good care, support your patient or client to attend a face-to-face consultation. 

No specific equipment is required to provide telehealth services. Services can be provided through telephone and widely available video calling apps and software.

Free versions of 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, their patient’s or client’s needs and satisfies privacy laws.

There is a range of information and resources about telehealth available. The list below is not intended to be exhaustive and the use of telehealth in your practice may be subject to additional requirements. You are encouraged to seek advice from your professional association, insurer or your employer if you have further questions about the use of telehealth in your practice.

• State and territory health departments have information and resources about telehealth.
• The Digital Health Cooperative Research Centre has launched a Telehealth Hub dedicated to telehealth resources. 
• The Australasian Telehealth Society provides a number of resources and publications relating to telehealth. 
• The Department of Health’s MBS website has information specific to the new temporary bulk-billing telehealth items for COVID-19.
• NSW State Insurance Regulatory Authority and Worksafe Victoria have released guidance about the use of telehealth.
• Your professional association(s) may have profession-specific information and resources about telehealth. 

Information for nurses and midwives 

• The Australian Nursing and Midwifery Federation has published Guidelines for telehealth on-line video consultation funded through Medicare. 
• The Australian College of Nurse Practitioners has published resources for nurse practitioners on telehealth. 

Information for pharmacists 

• The Department of Health has partnered with the Pharmaceutical Society of Australia to develop resources for pharmacists conducting medication reviews via telehealth. 

Information for physiotherapists

• The Australian Physiotherapy Association has developed information for physiotherapists on telehealth

This guidance is designed to support practitioners to use telehealth in response to the COVID-19 pandemic. It will be reviewed and updated as required during this time.

Last reviewed: 27 July 2020