Things to consider if you're considering Telehealth

It might be surprising to know that telehealth has been occurring for about 100 years now; there’s evidence of radios being used in the 1920s to provide clinical advice to people in remote locations. The way telehealth is conducted or provided has changed greatly over the years as the technology which supports it has changed and developed.

What is telehealth

Telehealth is providing health services remotely with the use of technology. There are many forms of technology which assist this such as phone calls, teleconference calls and sharing of images and videos.

There are many reasons why telehealth is used, however, they primarily boil down to the patient and practitioner not able to physically be in the same place. This may be because of geographical remoteness. Age or disability can prevent patients from travelling to their practitioner. And now social distancing requirements to reduce the spread of COVID-19 is making face to face appointments difficult and potentially unsafe. Therefore, telehealth is very beneficial, however it isn’t without risk. And these risks need to be considered and managed before this service is offered.

Is it right for you?

All business owners want to stay ahead of their competitors and provide the best service possible to their clients. However, this can mean at times business owners leap into something new too quickly without proper consideration and assessment.

Telehealth isn’t ideal for all health practitioners. Before you start offering telehealth services, do some research that will help you assess if it’s right for your business, your patients and the services you provide. Consider the pros and cons; think about how it’ll benefit your business but also consider the risks and challenges it’ll create.

You should consider developing an implementation plan to assist you in working through a range of factors to consider, such as:

  • Which services will suit telehealth, which won’t?
  • Who’ll assist with providing and supporting the technology required?
  • How will this new process be communicated with patients?
  • How will patients be assisted if they have difficulty with the technology, or simply
    don’t want to use it?
  • Will the process be phased in gradually?
  • How will it be evaluated?
Invest to do it well

The old saying ‘if something’s worth doing it’s worth doing well’ really does apply to implementing telehealth practices. When technology works well, it’s fantastic, when it doesn’t, it can cause a huge amount of frustration and time wasting. It’s therefore important that health practices don’t rush into implementing telehealth practices. It’s worth taking the time to ensure the tools and technology used are suitable for that individual practice. It’s also recommended that time is spent training all staff to be sure they understand how to use the new technology and what’s required of them with this change. Investing both time and money at the beginning will benefit the practice, practitioners and patients in the long term.

Some things stay the same

Much of what you already do, and what you’re required to do, as a health practitioner won’t change when using telehealth.

  • Communication – communication is always incredibly important for all health practitioners. However, it needs additional focus when consulting via telehealth. Practitioners may find they need to spend longer having conversations and should consider what questions they’ll ask the patient to be sure information has been understood.
  • Record keeping – you need to keep detailed and accurate records of all consultations and communications with patients, and this includes when using telehealth. It’s not just about actual consultations, even details about phone conversations with patients need to be recorded. If a consultation takes place via telehealth, make a note of this in the clinical record including the type of technology needed.
  • Informed consent – you need to ensure patients give their informed consent prior to treatment. Providing signed informed consent is a bit harder when consultations take place remotely, yet this can still be done in some cases. However verbal consent is sufficient. But remember, informed consent can only be given when the patient has been informed about the treatment, so sending a form to be signed to a patient before there has been any discussion or consultation isn’t appropriate. Also, verbal informed consent must be noted in the clinical record.
  • Privacy – you have a professional obligation to maintain the privacy and confidentiality of your patients. Therefore, when conducting a telehealth consultation, be sure it’s done in a private setting where no one in the background can hear or see what’s happening. Many forms of online communication, such as teleconferences, have a recording function. Consultations shouldn’t be recorded simply because they can. They should only be recorded if there’s a clear and specific reason for it and if the patient has given their consent.
  • Duty of care – health practitioners have a duty of care to all patients they treat. If a patient is being treated using telehealth and has never met the practitioner prior to this, this doesn’t change anything in terms of the practitioner’s duty of care to that patient.
  • Clinical decision making – Incorrect diagnosis is one of the greatest risks with telehealth, yet telehealth is no excuse for mistakes being made. If you don’t have the information needed to make a diagnosis or provide/recommend treatment, you must to find a way to get this additional information. Practitioners may want to consider if their assessment processes alter when using telehealth. Practitioners should also be sure they don’t allow the patient, or the treatment circumstances, convince them to provide treatment or advice that goes against their better judgement.
  • Practice within scope – when consulting using telehealth, the need to keep within your recognised scope of practice, and refer when the situation is outside of this, is no different.
  • Funding schemes – some funding schemes, such as private health insurers and Medicare, provide cover for telehealth, for some forms of treatment. As the treating practitioner, it’s your responsibility to be sure you’re meeting the requirements of the various funding providers and don’t claim for items which aren’t permitted.
  • Regulatory requirements – in addition to the above, any other requirements set by regulatory bodies need to be adhered to. This includes keeping on top of government advice and restrictions relating to COVID-19

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