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.
What is Telemedicine?
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 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
Ensuring that their identity and health records remain safe and confidential are a must for any patient. As such, the government as well as the Australian Medical Association, also known as AMA, have released guidelines on how to ensure that all telemedicine related transactions are secure and private.
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
Currently, no laws are mandating that private insurance companies cover telemedicine services, even at this time. However, due to Medicare being the more common type of health insurance used among Australians, this may not be a crucial factor especially as of 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 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.
With the current COVID 19 pandemic, the legal landscape of telemedicine 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.