The Medical Board of Australia, which is responsible for regulating medical practitioners in the country, has made some revisions to its telehealth guidelines.

WHAT IT'S ABOUT

A major change in the guidelines discourages the practice of prescribing without real-time direct consultation, whether in-person or via video or telephone, which the board claims is "not good practice."

"This includes asynchronous requests for medication communicated by text, email, live chat or online that do not take place in the context of a real-time continuous consultation and are based on the patient completing a health questionnaire when the practitioner has never spoken with the patient," the guidelines read.

Should it be done in any situation, a practitioner is compelled to "explain how the prescribing and the management of the patient were appropriate and necessary."

Meanwhile, the guidelines will also allow first-time consultations with a doctor using telehealth and the issuance of new and repeat scripts as part of a telehealth consultation. 

Based on a media release, these changes to the telehealth guidelines will take effect on 1 September.

WHY IT MATTERS

The Medical Board proposed changes to the telehealth rules last year in December to keep first-time telehealth users safe. It has been cracking down on practitioners who are conducting what is considered an "unsafe" form of online prescribing following reports on doctors prescribing drugs of dependence via telehealth.

While the board said it considered feedback in defence of asynchronous prescribing, it maintained that "prescribing medication should not occur in isolation."

"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," Medical Board chair Dr Anne Tonkin stressed. 

The revised guidelines recognise telehealth as an "important feature of healthcare in Australia." It emphasised that real-time doctor-patient consultation is key to safe prescribing. "A doctor who has not consulted directly with the patient and does not have access to their medical records is unable to exercise good, safe clinical judgement," Dr Tonkin claimed.

THE LARGER CONTEXT

In March, the Medical Software Industry Association, the peak organisation for the health technology industry, appealed to the Medical Board to hold off changes in its telehealth guidelines in fear of "serious unintended" consequences. The organisation took particular concern about disallowing asynchronous prescribing, which it claimed is an "analogue approach in a digital world." It maintained that prescriptive rules for the use of technology must not keep doctors from exercising professional judgment. 

ON THE RECORD

"Telehealth is here to stay. It plays an important role in healthcare in Australia and has opened great opportunities to improve access to and delivery of care, including to rural and remote patients and people living with disadvantages. The interaction between a doctor and their patient is an important element in all consultations, including telehealth consultations," Dr Tonkin said.