Text-based consults, prescriptions and referrals provided without real-time consultation are no longer considered ‘good practice’ by the Medical Board of Australia.
The Medical Board of Australia’s updated guidelines for telehealth consultations have now come into effect.
While standards remain consistent with previous guidelines, the most significant change concerns asynchronous services provided in the absence of a real-time, doctor-patient consultation, which are no longer considered good medical practice.
Exceptions may be made for prescriptions provided without a consultation if a patient is consulting with their usual medical practitioner or a practitioner with access to the patient’s clinical records.
“Prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board,” the MBA guidelines state.
“This includes asynchronous requests for medication communicated by text, email, live-chat or online that do not take place in the context of a real-time continuous consultation and are based on the patient completing a health questionnaire, when the practitioner has never spoken with the patient.
“Any practitioner who prescribes for patients in these circumstances must be able to explain how the prescribing and the management of the patient was appropriate and necessary in the circumstances.”
With regards to international consultations, the guidelines state that doctors consulting with Australian patients must be registered with the MBA and meet all relevant registration requirements, including professional indemnity insurance.
Doctors must also inform patients of Medicare billing rules for telehealth consultations if they or the patient is located outside Australia.
MBA Chair Dr Anne Tonkin said the guidelines had been updated to address concerns regarding good practice and patient safety after an explosion in online businesses offering asynchronous telehealth services.
“‘The interaction between a patient and a doctor is the foundation of any consultation. Providing healthcare, including prescribing, ordering tests and issuing certificates, relies on a doctor’s skill and judgment, including what is safe and appropriate based on the patient’s history,” Dr Tonkin said.
“The guidelines close the gap that’s sprung up between online healthcare business models, including prescribing, and good medical practice and protect patients.”