Telehealth essentials

• Your provision of telehealth is subject to the same standards of care as in-person healthcare.
• Telehealth has limitations and is not suitable for all patients.
• There are specific requirements for prescribing via telehealth and for financial consent, including Medicare.

Telehealth describes the delivery of healthcare services remotely, using telecommunication technologies to facilitate interactions between yourself and a patient. It encompasses a range of methods, primarily involving audio and video communication, to enable consultations, diagnosis, treatment, monitoring and education from a distance. While the ideal telehealth encounter may incorporate a video component, it can also occur solely through telephone communication. 

Professional standards

No matter what method you use, the Medical Board of Australia expects you to comply with good medical practice every time you consult a patient. The standard of care provided in a telehealth consultation must be safe and as far as possible meet the same standards of care provided in an in-person consultation.

To meet your obligations under privacy legislation, you need to choose a platform that has adequate measures to protect the privacy and security of your patient’s health information. The Australian Department of Health has developed a Privacy checklist for telehealth services to assist you to comply with your privacy obligations when delivering telehealth services.

The Medical Board of Australia’s guidelines for Telehealth consultations with patients require you to have access to secure, reliable technology that is fit for clinical purpose and to avoid using a personal account where possible.

While telehealth is a valuable option for some of your patients, it is not appropriate for all medical consultations. In most cases it should not be considered a routine substitute for in-person consultations. It is important you are aware of the limitations and risks associated with telehealth. 

Physical assessment

Your ability to conduct a thorough physical assessment during a telehealth consultation is limited, which poses significant risk.

There are however some techniques you can use to help mitigate this risk such as:

• using a patient’s home equipment (e.g. BP or glucometer)
• asking the patient to conduct a functional assessment to assess movement
• asking another healthcare professional who is present with the patient to complete a physical examination and relay their findings to you.

Although these steps can help reduce the risk of not being able to conduct a physical assessment, there may be times when you can’t sufficiently mitigate this risk. It is important to recognise these instances and consider:

• organising for the patient to come in for an in-person consultation
• involving another health practitioner such as a community nurse or allied health practitioner.

Pre-existing clinical relationship

Establishing and maintaining a clinical relationship with your patient underpins your ability to provide high-quality healthcare and mitigate potential risks. This is especially important when conducting a telehealth appointment. Without a pre-existing clinical relationship, patient care may be compromised.

Potential risks include:

• Limited access to clinical records – inhibits your ability to thoroughly assess the patient’s medical history, which is essential for making informed treatment decisions.
• Inappropriate prescribing – without a thorough understanding of the patient’s medical history and current health status, there is an increased risk of prescribing medications that may not be suitable or safe for the patient.
• Prescription shopping – having a pre-existing clinical relationship allows you to better monitor and address potential prescription shopping behaviours.

Inadequate follow-up

Ensuring adequate follow-up after a telehealth consultation, particularly for a patient who is not a regular patient, is essential to maintain continuity of care and promote patient safety. Key risks of inadequate follow-up include:

• Lack of continuity of care – patients without an established relationship with the treating doctor may experience gaps in care if follow-up appointments are not scheduled or if there is insufficient coordination of care between healthcare providers.
• Missed monitoring – there is a risk the patient's condition and treatment progress may not be properly monitored, resulting in emerging health concerns or complications not being identified.
• Medication or treatment mismanagement – patients may not receive timely adjustments to their treatment plans or prescriptions, increasing the risk of medication errors or adverse drug reactions.

If the telehealth consultation is not with your regular patient, you should:

• Share relevant medical information with the patient's regular treating doctor, such as treatment plans or recommendations, changes in medication, diagnostic results, and follow-up instructions.
• Coordinate follow-up care with the patient's regular treating doctor or other healthcare practitioners including scheduling additional appointments, monitoring the patient's progress, and addressing any ongoing healthcare needs.

Billing processes

In telehealth consultations, it is essential patients understand and consent to the billing process. Inform them of fees associated with the consultation, and explain out-of-pocket expenses (fees not covered by Medicare or private health insurance).

Before starting the telehealth consultation, clearly communicate the billing process and obtain the patient's consent to proceed with the consultation under those terms. This transparency helps build trust and ensures patients are fully informed about the financial aspects of the telehealth service.

Bulkbilling

When bulkbilling telehealth consultations, there are specific requirements relating to how consent for billing Medicare is obtained from patients. There have been changes to this process, with further legislated alterations commencing in January 2026.

For information regarding the changes, see Improving the assignment of benefit process | Australian Government Department of Health and Aged Care

For information regarding current requirements, see MBS Online - Verbal assignment of benefit arrangements for telehealth services

Electronic prescribing is now widely available in Australia and provides an option for supporting telehealth consultations and enabling supply of medicines.

The Australian Department of Health and Aged Care has a factsheet which outlines state and territory rules for prescriptions via telehealth with useful links and the circumstances when digital image prescriptions can be used.

Interstate prescribing

Understanding where your patient lives or is currently residing is important when prescribing using telehealth. If your patient is in a state or territory different from yours, not only must you adhere to the requirements of your own state or territory, but you must also adhere to the regulations governing where your patient is.

Every state and territory has different legal requirements when prescribing high risk medication. The Royal Australian College of General Practitioners has a summary of state and territory legislation for prescribing S8 medications with links and contacts.

Prescribing drugs of dependence

Prescribing drugs of dependence during a telehealth consultation requires adherence to the same regulations and best practice as for an in-person consultation. See Avant’s Prescribing drugs of dependence factsheet. 

If you don’t have an existing and ongoing clinical relationship with a patient then it is generally discouraged to prescribe drugs of dependence for them, unless there are exceptional circumstances.

Medical indemnity cover

In some instances, telehealth may not be covered under your medical indemnity insurance. It is important that you check with your medical defence organisation, especially if:

• telehealth is provided while you or the patient are outside Australia
• healthcare is delivered based solely on electronic transmission without prior in-person (including phone or photo) consultation
• you are a resident or registrar and provide telehealth services outside your hospital or training position.

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.