So-called ‘national’ standards remain more aspiration than regulation. But it’s a good start, say the developers.
The “National Telehealth Standards” were launched with much fanfare at Parliament House this week by a group of MPs, advocates and industry leaders.
They are the outcome of a national, patient-led collaboration convened by Patients Australia and informed by extensive consultation with patients, clinicians, digital health providers and policy experts.
According to Healthdirect CEO Bettina McMahon, the idea was formed around 18 months ago during a consultation with Patients Australia.
“They made the observation that since covid, telehealth has really taken off. It’s used by many more patients. But there’s not really a lexicon around the different types of telehealth services that can be provided,” she told Health Services Daily.
Patients Australia put its hand up to develop the Australian Telehealth Standards Consortium, which included Healthdirect, Medibank, HCF, BUPA, nib Group’s Honeysuckle Health, Updoc, Eucalyptus, Healthengine, MedAdvisor, MOSH, Medmate, 13Sick and Wesfarmers Health.
Patients Australia CEO Lisa Robins said it was critical that public confidence keep pace with the rapid growth of telehealth.
“Telehealth has transformed access to care for millions of Australians, particularly those in regional, rural and remote communities,” she said.
“But access alone is not enough. Patients need to know that telehealth is safe, high quality and accountable. These National Telehealth Standards provide a clear, patient-led benchmark that supports safe, high-quality telehealth care and helps build confidence as virtual care continues to expand.”
The announcement of the standards has drawn criticism, however, with some saying it’s confusing and misleading that is no government intervention, even though Healthdirect, a government body, was part of the consortium.
GP Dr Max Mollenkopf wrote on LinkedIn:
“This is confusing and a bit misleading. Despite this post there aren’t actually any national government standards for telehealth. We should probably rename them as the ‘industry-led aspirational standards in the absence of any government movement’.
“This is yet another industry group consortium putting forward what they HOPE will become the national standards,” he continued.
Others agreed, including executive director of Health Consumers’ Council WA, Clare Mullin:
“I’d like to have seen independent patient/consumer organisations involved in this work – and by that I mean patient groups that are free of industry influence.”
Ms McMahon highlighted, however, that it was common for industry bodies to see a vacuum and crack on with standards rather than waiting for government.
“If you look at clinical guidelines, they’re developed, usually by the AMA, or the RACGP red book, or part of the community that develops it,” she said.
She admitted that Dr Mollenkopf’s point was right – seeing the title of “national standard” could imply that the standard had been set and conditions were in place already where there are consequences.
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“He calls it an aspirational standard. I would say it’s a standard developed through the relevant community, about what good looks like,” she said.
“But he’s quite right. It’s landed without any of the architecture around it to create those consequences.”
Ms McMahon said there were two parts to standard setting. One was the actual writing the standards, and the other was enforcing them. They’re commonly done at different times.
“Over time, as those conditions mature, multiple levers arise, and they’re not always architected by one grand mind,” she said.
Often the government might observe the development across the community, look at the legitimacy of who was involved when they work out whether to embed conformance.
When asked about its endorsement of the telehealth standards, the Department of Health, Disability and Ageing told HSD that the standards were developed independently of government as a sector-led initiative.
“The Department of Health, Disability and Ageing welcomes efforts that support safe, high-quality virtual care for consumers,” a spokesperson said.
Ms McMahon said the standards had a good chance of succeeding because those who were doing it at scale were involved in creating them.
“They bring their practical understanding about what the issues are and what’s feasible. So they’re implementable,” she said.
“They had skin in the game. You wouldn’t participate in the development of a standard if you didn’t have any intention of ever implementing it yourself,” she said.
As Ms Robins wrote:
“Industry self-regulation can be very valuable, when done well – the Medicines Australia code of conduct is one example that comes to mind.
“If we look forward, we are at a point where collectively, and collaboratively, we can do a lot of good for patients by building on the work that has been done so far.”
Ms McMahon admitted there needed to be enforcement at some point, however.
“We’ve seen with any standard, unless some of those sticks come in eventually, the adoption might be a bit lumpy,” she concluded.
