‘Online telehealth clinics in Australia are insufficiently regulated’, says senior legal counsel for virtual health start-up Eucalyptus.
Australia should look to the UK as a roadmap for regulation of online telehealth providers, according to telehealth start-up Eucalyptus.
Speaking during the “graveyard shift” – just preceding lunch – at yesterday’s Medical Software Industry Association Summit in Sydney, senior legal counsel for Eucalyptus, Lyndon Goddard, opened with a curveball.
“In our view, online telehealth clinics in Australia are insufficiently regulated,” he said.
“You heard that right.
“Specifically, we think there’s an absence of voluntary level and compulsory government-endorsed safety and quality standards applying to them.”
The reality is, there are many telehealth services in Australia and lots of patients who use them, said Mr Goddard.
“We should expect the telehealth services, just like any other health service, to provide safe and high-quality care,” he said.
“We recognise that if any health service doesn’t provide that, there’s a real risk of potentially widespread patient harm as well as poor health outcomes more generally.
“So, what do we do about how we ensure that these expectations are met?
The answer is to define minimum standards of safety and quality, and then promote their implementation through regulation or accreditation, or both, he continued.
“Sometimes the rules are compulsory, sometimes they’re voluntary, perhaps incentivised,” Mr Goddard said.
“But it’s important to keep in mind that the mere existence of accreditation standards is not usually enough to make anyone actually comply with them.”
While regulation around doctors and medications are fairly steadfast, standards and regulation around some clinical systems in which doctors practice, such as the telehealth space, were sparse, said Mr Goddard.
In hospitals, it is compulsory to be accredited to the NSQHS standards.
GP clinics are incentivised to be accredited according to the RACGP’s standards to qualify for WIP and PIP payments.
But outside of brick-and-mortar healthcare spaces, there are no national uniform standards on safety and quality.
“The [Australian Commission on Safety and Quality in Health] has published digital mental health standards, but naturally, they’re only relevant to the sliver of the industry that focuses on psychological counseling,” he said.
“There is also the EQuIP6 standards that are published by the Australian Council on Healthcare Standards.
“That’s not a government body, but it’s published these standards designed for health services that aren’t eligible to qualify for the NSQHS standards.
“The problem is they’re not tele-specific. We have, however, got ourselves accredited to them voluntarily because they’re the closest we can find in Australia.
“But they’re not a complete answer to that gap.”
The ACSQH is currently working on virtual care standards which should satisfy the gap, according to Mr Goddard.
“We don’t know when they’ll be finished yet, but even when they are complete, there is an unanswered question about how we can ensure that people actually comply.”
The UK’s health system is rarely used as an example when it comes to a well-functioning healthcare system.
But in the case of regulation of telehealth services, according to Eucalyptus, we have a lot to learn from our colleagues across the pond.
“In the UK, there is actually a distinction between the regulatory bodies that govern individual health practitioners … they’re essentially equivalent to the AHPRA bodies that we are familiar with in Australia,” said Mr Goddard.
“[The other regulatory bodies] don’t really have an equivalent in Australia, but they’re designed to regulate, among other things, the clinical system within which the practitioners operate.
“But also unlike AHPRA, they act proactively, rather than just reactively on the basis of complaints.”
The General Pharmaceutical Council, or the GPhC, regulates telehealth in the UK – which use pharmacists to prescribe medication.
Related
The council regularly audits for compliance with guidelines, according to Mr Goddard.
“This is, we think, a rigorous and sophisticated method of regulation, which we don’t really have an equivalent of in Australia, and which we think Australia could do well to replicate.
“There is actually a further incentive in the UK to strive for the highest possible standards of safety and quality of new health service beyond just the minimum standards.
“That comes in the form of the National Institute for Health and Care Excellence.
“And the purpose of that is that they will provide recommendations to and then funding by the NHS if you get the recommendation.”
Eucalyptus’ weight-loss platform, Juniper, received NICE endorsement earlier this year.
