Telemedicine is a relatively new addition in Australia, having been introduced within the last ten years. During its inception, telehealth has evolved in the country not only with regards to the technology involved but also with how the government handles and allows this new model of health care. Legislation regarding any new type of initiative can be difficult, and telehealth is no different. There are some restrictions as well as policies on how doctors and patients can use telehealth. On the other hand, other parties such as insurance companies also have different regulations on how telehealth is covered.
Here, we will discuss the legal aspects of telemedicine in Australia, and these would include rules and policies covering the use of this technology as an option for alternative health care.
Telemedicine can take many forms. It can involve face-to-face interactions between doctors and patients, or it can use images captured by webcams or other devices and sent over the Internet for analysis by healthcare professionals at remote locations. Telemedicine can also be used in place of in-person visits by allowing physicians to monitor patients from afar using video conferencing technology or mobile health (mHealth) applications on smartphones and tablets.
Some forms of telemedicine are regulated by state laws, while others are regulated federally.
What is Telemedicine in Australia?
Telehealth is the use of technology to facilitate consultations, diagnosis of medical conditions, and treatment of patients. It utilizes video conferencing and other communication tools to eliminate the need for close physical contact between the health care provider and the patient.
Store and forward technology also allows for lab tests and scans to be done in one location and sent to a specialist in another location for review. This greatly minimizes turnaround time when it comes to diagnosing diseases, and it can also save time for the patient as they do not need to go multiple times to the hospital just to get results.
Benefits of telemedicine include:
- Lower overhead costs
- A higher level of patient engagement and satisfaction
- Decreased patient costs
- Less chance of the spread of infection
- Less need to travel
- Better work-life balance
- Access to urgent medical attention
Availability and Access
Before the COVID 19 pandemic, there are restrictions on as to who can avail of telemedicine in Australia services. General rules included that the patient be located in a remote or rural location and that they are not within a fifteen-kilometre distance with the practitioner that they would like to speak to.
However, the Australian government has just recently allowed all citizens to avail of telemedicine services in order to prevent the risk of infection. This comes from the heels of the government pumping in over a billion dollars in additional funding to further bulk up Medicare funds.
Doctors will also be incentivized as the government promises double the bulk billing rates for concession card holders, for those aged 16 years and below, as well as for those more vulnerable to COVID 19. While bulk billing prevents additional fees from being added, this also helps lessen the specialists’ risk of infection during these times.
How this policy will change once the pandemic has passed, however, remains to be seen.
Security and Privacy
The safety and confidentiality of patient identities and health records are paramount in telemedicine in Australia. To ensure the security and privacy of all telemedicine-related transactions, both the government and the Australian Medical Association (AMA) have issued guidelines.
Some regulations include that software used is HIPAA compliant. HIPAA refers to the rules and standards set by the Australian Health Practitioner Regulation Agency or AHPRA. The only software that has the HIPAA seal is allowed to be used for telemedicine purposes.
However, with the current issues surrounding the COVID 19 pandemic, these regulations have been a little more flexible. As such, typically non-HIPAA approved software such as Skype may be used in unavoidable conditions. There are also policies and regulations with regards to using other means of communications such as email or SMS.
In most cases, informed consent coming directly from the patient is also required. These can refer to explicit consent with regards to sending data to other locations, especially for those located outside the country.
Other information that patients must be informed of may include any external fees, risks of the treatment, alternatives, and how you will be using their personal information, among others. Informed consent is one of the requirements before consultation or treatment can proceed.
Any violation regarding security or privacy breaches may result in penalties as mandated by the AMA and the Privacy Act of 1988.
Private Insurance Coverage
At present, there are no laws requiring private insurance companies to cover telemedicine in Australia. However, given that Medicare is the more prevalent type of health insurance among Australians, this may not be a significant issue at this time.
Nevertheless, it would seem as if, required by law or not, private insurers are strongly behind the telemedicine initiative as many companies do cover telemedicine services, although there might be some restrictions on which specific items are being covered.
Legal Risks for Health Practitioners
Despite the benefits of telemedicine, this type of technology still holds certain risks, especially when it comes to issues of malpractice. Lawsuits can ensue for telemedicine in the same way as the traditional doctor and patient exchanges.
As telemedicine in Australia allows doctors to technically communicate with patients from all over the world, it is also important to note that Australian law dictates that where the patient is located defines where the actual care has been performed.
This means that, by Australian law, doctors cannot perform telemedicine on patients outside of the country unless they are licensed or registered to be able to do so.
Many insurance companies offer coverage for medical indemnity, and not only do they assist in the event of lawsuits, but they also provide sound advice on the proper telemedicine practices, or if whether telemedicine is the recommended course of action at all.
State and Federal regulation of health services and professionals AU
The primary regulatory mechanisms for health professionals are state and federal laws, regulations, and licensing requirements. State licensure is generally required for all health care providers except those who work for the federal government, who are subject to federal regulations. The state’s authority to regulate health professionals is based on its power to protect the public from unqualified providers.
Federal licensure is required for certain types of practitioners, including physicians, physician assistants (PA), nurse practitioners (NP), nurses and pharmacists. Federal law also regulates many aspects of medical practice that states do not license or certify specifically. For example, physicians must meet certain requirements to receive Medicare reimbursement for services provided to their patients.
There are two types of health professionals:
State-licensed health care professionals are licensed by a state agency. They must pass a national board examination and be certified as an expert in their field. State-licensed professionals include doctors, nurses, dentists and pharmacists.
Those who do not hold state licenses include massage therapists, acupuncturists, chiropractors and others who are regulated by the states’ boards of registration or boards of nursing. The laws regulating these professions vary widely from state to state.
Conclusion
With the current COVID 19 pandemic, the legal landscape of telemedicine in Australia has drastically shifted. As to whether regulations and restrictions would remain in the coming months and years would depend on national legislation. What can be said, though, is that there are many rules that doctors, patients, and other stakeholders involved in telemedicine should abide by, and they must be fully aware of these conditions before seeking and conducting telemedicine for their respective needs.
The Australian Government Department of Health provides much relevant information regarding current and changing rules and regulations regarding telemedicine for your information and use. You might also be interested in Amazing History of Telemedicine: How It Began
FAQs
- What is telemedicine?
Telemedicine is the use of medical information exchanged from one site to another through electronic communications to improve a patient’s clinical health status. Telemedicine in Australia includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunication’s technology.
- What is the legal status of telemedicine in Australia?
There is no specific legislation in Australia governing the practice of telemedicine. However, the delivery of telemedicine services must comply with the same general legal principles that apply to the provision of all health services in Australia.
- What are the potential legal risks associated with the practice of telemedicine?
The potential legal risks associated with the practice of telemedicine include:
• Breach of patient confidentiality and privacy
• Inappropriate or incorrect diagnosis and treatment
• Negligence
• Fraud
- How can these risks be minimised?
The risks associated with the practice of telemedicine in Australia can be minimised by:
• Ensuring that all telemedicine services are provided in accordance with applicable professional standards and codes of conduct
• Obtaining the informed consent of patients before providing any telemedicine services
• Maintaining accurate and up-to-date records of all telemedicine consultations
- What are the specific legal requirements for the provision of telemedicine in Australia?
There are no specific legal requirements for the provision of telemedicine in Australia. However, all health service providers must comply with the general legal principles that apply to the provision of all health services in Australia, including the requirement to maintain professional standards of care.