Or does it? AHPRA has sent out mixed signals on what it considers to be good telehealth practice.
It has been a curious day at the TMR headquarters, with the health practitioner regulator issuing a press release which claims one thing and guidance which claims another.
On Tuesday morning, AHPRA put out a media release which appeared to give new information on telehealth standards for all prescribers.
The release had a list of “good telehealth practices”, including: “only prescribing if you’ve consulted with the patient face-to-face before”; sharing information in a way the patient can understand; getting all necessary medical history; gaining informed consent; letting patients know when telehealth is not appropriate; and confirming the patient is who they say they are.
It also listed the revisions as including “revised telehealth guidance [to ensure] proper consultation and practitioner accountability” and changes that “reflect concerns around unethical practice and emerging business models focused more on profit than patient safety”.
AHPRA CEO Justin Untersteiner said that, while telehealth had been a boon for some patients, the regulator wanted to “make sure that convenience doesn’t come at the cost of safety or quality”.
TMR,like the Australian Financial Review, initially understood the reference to face-to-face consults in the AHPRA release to mean that the regulator only considered telehealth to be acceptable in situations where the prescriber and patient had an established, in-person relationship.
Clinics like the Eucalyptus-owned Juniper, Kin and Pilot, as well as nib-owned Midnight Health and Wesfarmers-owned InstantScripts all employ a model whereby the patient never physically meets their doctor.
If accurate, the new guidance from AHPRA would throw into question the business practices of all of these telehealth operators, potentially putting many millions of dollars in financial backing at risk.
Closer examination of the actual updated guidance documents, however, told a slightly different story.
While it does warn that the National Boards do not support or consider it good practice to prescribe medicine for a patient that a practitioner has never consulted face-to-face, it also lists real-time video or telephone consults as equivalent to face-to-face.
In fact, it appears that the regulator is more specifically concerned with cracking down on asynchronous care rather than all telehealth-only prescribing.
This would fit better with the existing 2023 telehealth guidelines, which focus on the importance of real-time consultations.
The full statement on telehealth prescribing in the new guidance document reads:
“Be aware National Boards do not support or consider it good practice to prescribe medicine or other assistive technologies (for example orthoses or glasses, or mobility aids) for a patient that a practitioner has never consulted, whether face-to-face, via video or telephone.
“This includes requests for medicine or other health services communicated by text, email or online that do not take place in real-time or are based on the patient completing a health questionnaire where the practitioner has not formally consulted with the patient.
“The Boards do not consider an online chat to be a synchronous (in real time) consultation.
“Any practitioner who prescribes for patients in the above circumstances may be asked to explain how the prescribing and management of the patient was appropriate and necessary, and how they assessed that the patient was a suitable candidate for any treatment provided.”
TMR has contacted AHPRA requesting urgent clarification. It did not respond before deadline.
It’s not the only recent movement in the telehealth space.
Just last week, news broke that nib-owned telehealth platform Midnight Health was fined $198,000 for alleged advertising breaches related to weight-loss drugs.
The Pharmaceutical Board of Australia has also recently issued guidance for pharmacists on filling medicinal cannabis scripts, warning specifically about business models that “only offer the prescription and supply of a single product or class of drug and use online questionnaires that coach patients to say ‘the right thing’ to justify prescribing”.
This story was updated at 3:45pm.
