Telehealth

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Telehealth and Video Consultations

The Coronavirus pandemic continues to be a major health issue to all. Minimising contact with others appears to be a vital measure in controlling spread and new cases. Facilitating consultations via video or teleconference is a vital step in adhering to isolation guidelines whilst providing care to patients.

Which patients MUST have a Telehealth consultation?

From RACGP website (https://www.racgp.org.au/coronavirus#update16)

A suspected case is currently defined in the Communicable Diseases Network Australia (CDNA) National Guidelines for Public Health Units as meeting the criteria in any of the three categories below:

A – If the patient satisfies epidemiological and clinical criteria

Epidemiological criteria:

International travel in the 14 days before illness onset

OR

Close contact in 14 days before illness onset with a confirmed case of COVID-19

(a close contact is defined as requiring EITHER greater than 15 minutes face-to-face contact in any setting with a confirmed case in the period extending from 24 hours before onset of symptoms in the confirmed case, OR sharing of a closed space with a confirmed case for a prolonged period (e.g. more than 2 hours) in the period extending from 24 hours before onset of symptoms in the confirmed case. Further information is available in the National Guidelines for Public Health Units)

AND Clinical criteria:

Fever (≥38C*) or history of fever (eg night sweats, chills)

OR

Acute respiratory infection (eg shortness of breath, cough, sore throat) with or without fever

 

B – If the patient has severe bilateral community-acquired pneumonia (critically ill*) and no other cause is identified, with or without recent international travel, they are classified as a suspect case

*requiring care in ICU/HDU, or for patients in which ICU care is not appropriate, respiratory or multiorgan failure. Clinical judgement should be exercised considering the likelihood of COVID-19.

 

C – If any healthcare worker with direct patient contact has a fever (≥38C*) AND an acute respiratory infection (e.g. shortness of breath, cough, sore throat), they are classified as a suspect case

*It is recommended that temperature is measured using a tympanic, oral or other thermometer proven to consistently and accurately represent core body temperature.

 

Who is eligible for the Medicare rebate for Telehealth consultations?

Medicare website (http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/content/news-2020-03-01-latest-news-march)

A vulnerable/isolated patient is:
  1. a person who has been diagnosed with COVID-19 virus but who is not a patient of a hospital; or
  2. a person has been required to isolate themselves in quarantine in accordance with home isolation guidance issued by Australian Health Protection Principal Committee (AHPPC)*; or
  3. a person who is considered more susceptible to the COVID-19 virus being a person who is:
  4. at least 70 years old; or
  5. at least 50 years old and is of Aboriginal or Torres Strait Islander descent; or
  6. is pregnant; or
  7. is a parent of a child under 12 months; or
  8. is already under treatment for chronic health conditions or is immune compromised; or
  9. a person who meets the current national triage protocol criteria for suspected COVID-19 infection.

* Department of Health (https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert)

  • You must self-isolate if any of the following applies to you:
  • you have COVID-19
  • you have been in close contact with a confirmed case of COVID-19
  • you arrived in Australia after midnight on 15 March 2020
Which patients need to come into the rooms to be seen?

Patients who need clinical examination or minor procedures such as stent removals, removal of IDCs or need education from the doctor or nursing staff will need to come in to the office.

If the patient meets any of the above criteria, they will NOT be able to attend for a ‘in-person’ consultation and the case needs to be discussed with the doctor.

How will the consultations be carried out?

Consultations will be conducted using either video-conferencing facilities or via a phone call for those who are unable to participate in a video-call.

What equipment or software do patients need to have a video consult?

Your doctor will conduct video-consultations with video-conferencing software such as GPConsults, Zoom or Skype. You will receive more information on how your appointment will be managed from your doctor’s secretary in plenty of time before your appointment.

Once clicking on an invitation link in the agreed software, patients will be taken to their web browser and will await the consultation to start. It is important to connect ahead of your allocated appointment time so that your doctor can initiate the video-consultation in a timely manner.