Urgent call to expand telehealth criteria

If doctors could see a majority of their caseload virtually, they would be reducing the risk of COVID-19 transmission in their clinic. So why not do that?

Unless we broaden telehealth criteria to allow a majority of patients to see a doctor virtually, we will see more doctors sidelined and growing transmission of COVID-19 through the healthcare system, the AMA says.

The AMA, The Australian GP Alliance (AGPA) and the GP Deputising Association (GPDA) are calling for the federal government to extend the eligibility criteria on the recently announced MBS telehealth item numbers to reduce the total amount of face-to-face consults.

AMA President Dr Tony Bartone said infection in the community could be reduced by increasing the amount of ‘well’ patients treated at home.

“Most patients will present with little or no symptoms. These measures are all about having our health system prepared and properly resourced to stop the spread of the virus,” Dr Bartone said.

Currently the patients eligible for telehealth or phone item numbers are those who either have been diagnosed with COVID-19 but are not a hospital patient, or have been instructed to self-isolate.

In addition patients who are deemed vulnerable including those aged over 70, indigenous people aged over 50, pregnant women, parents of an infant under 12 months, those being treated for a chronic condition or those who are immunocompromised.

But doctors are unable to claim for these MBS item numbers unless they have a face-to-face consult history with the patient in the previous 12 months.

However doctors from the same practice are now able to consult with another doctors at-risk patient, provided they have attended the practice in the year prior.

Dr Mukesh Haikerwal, GP and director of AGPA, said previous limitations were unhelpful at a time when doctors services were already being stretched thin.

This would allow more vulnerable people to access healthcare, without having to put themselves at risk in waiting rooms.

In addition, doctors who are unable to attend their practices because of self-isolation measures could benefit from being able to see more patients via phone or video consultations.

Dr Nathan Pinskier, GP and President of the GPDA, gave the example of a doctor in his practice who had developed symptoms and was quarantining while awaiting the pathology results. They were not eligible to access the MBS item numbers to continue seeing patients via telehealth because they were not considered at risk.

“The telehealth rules are inadequate and too restrictive,” Dr Pinskier said.

“They are exposing the Australian public and doctors to unnecessary risk. In essence, all patients in general practice should be managed by telehealth unless a face-to-face consultation is absolutely necessary.”