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Digital & Innovation

New telehealth guidelines to safeguard online prescribing, but concerns arise for young and rural Australians

Health Industry Hub | June 2, 2023 |

Digital & Innovation: In a move to address the growing concerns surrounding online prescribing business models, the Medical Board of Australia has released updated telehealth guidelines. These guidelines, which were shaped by input from the community and medical professionals, are set to take effect on 1st September, however, but some warn that young and rural Australians could suffer.

With a staggering 770 submissions received during the consultation process, it is evident that the issue of telehealth and its implications for medical practice has struck a chord. The majority of the submissions, over 650 of them, came from customers of two asynchronous prescribing companies. Interestingly, at least one of these companies incentivised consumers by offering a chance to win a $500 prize for completing a survey about their services. Such a response demonstrates the concern within the community regarding online prescribing practices.

The revised telehealth guidelines encompass several key points that will shape the future of healthcare in Australia. First and foremost, telehealth consultations are recognised as a vital component of the healthcare system, providing opportunities to improve access and delivery of care, particularly for rural and remote patients as well as those facing socioeconomic disadvantages.

According to Dr Anne Tonkin AO, Chair of the Medical Board of Australia, “Telehealth is here to stay.”

However, the guidelines emphasise that real-time doctor-patient consultations remain essential for safe prescribing. The use of questionnaire-based asynchronous web-based tools, without a real-time consultation, is deemed inadequate and not in line with good medical practice. The interaction between a doctor and their patient, whether in person or via telehealth, is regarded as a crucial element of all consultations.

Commenting on the updated guidelines, Professor Steve Robson, President of the Australian Medical Association (AMA), acknowledged the necessity of these revisions. He recognised the rapid growth of telehealth in recent years, largely driven by the Covid-19 pandemic, and highlighted the importance of clear guidance for doctors.

“The guidelines strike the right balance by ensuring telehealth remains accessible for patients, while at the same time discouraging poor models of care that can result in missed or misdiagnosis. Telehealth should be seen as an additional tool to assist doctors to provide good medical care to their patients. It should be used to augment and build on the care provided by a traditional face-to-face consultation,” Professor Robson said.

Former deputy chief medical officer and Australian Patients Association Health Reform Ambassador, Dr Nick Coatsworth, has warned that young and rural Australians could suffer if the new regulations crack down too hard on telehealth companies prescribing crucial drugs. He also noted that the Medical Board of Australia’s early consultation paper sparked problems for doctors providing telehealth services as it led to major insurers removing medical indemnity insurance for online consultations.

“The big question is what happens to the tens of thousands of young Australians who are digitally aware and have come to utilise these types of services and if the regulator pushes too far to restrict them then the regulator will create an access problem for young and rural Australians. If they do go further … it‘s a significant worry for me in terms of problems it can create with access to medicines,” Dr Coatsworth said.

Dr Tonkin further stressed the importance of providing safe and high-quality care in telehealth consultations. It is strongly discouraged for doctors to prescribe medication or provide healthcare without a direct consultation and access to the patient’s medical records. The Board believes that a doctor’s ability to exercise sound clinical judgment depends on direct engagement with the patient and a comprehensive understanding of their medical history.

While the guidelines discourage prescribing without a real-time consultation, there are certain circumstances in which a patient’s usual medical practitioner or another health professional with access to the patient’s clinical records can prescribe without a consultation. This provision ensures that patients have access to necessary medications while maintaining safety standards.

“Prescribing medication is not a tick and flick exercise. It relies on a doctor’s skill and judgement, having consulted a patient, and recognises that prescription medication can cause harm when not used properly,” Dr Tonkin emphasised.

As the implementation date of 1st September approaches, these updated telehealth guidelines will play a crucial role in shaping the future of healthcare in Australia. By closing the gap between online prescribing business models and good medical practice, these guidelines aim to ensure that telehealth remains a valuable and safe option for patients, further improving accessibility and delivery of care across the country.

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