Telehealth services are now more than ever being utilised to provide medical treatment to patients. The benefits work for both parties involved – patients can continue to receive treatment in the comfort of their own home, whilst medical practitioners are able to continue to practice in relative safety. Furthermore, in terms of a public policy perspective, telehealth is playing an important role in easing pressure on personal protective equipment supplies and other resources needed to reduce the spread of COVID-19.
Whilst the benefits are numerous, the rapid uptake and usage of telehealth services has also presented risks to practitioners when providing treatment to patients. One of the most common pitfall relates to obtaining informed consent. The RACGP recommends that when providing telehealth services, there should ideally be an existing relationship with the practitioner or the practice.
Informed consent
One way to mitigate against these limitations is to be alert to the benefits and risks of telehealth including when obtaining informed consent from a patient.
On 16 April 2020, AHPRA and the Medical Board of Australia published telehealth guidance reaffirming that practitioners should adhere to the same professional standards in telehealth consultations as they do for in-person consultations. This includes obtaining informed consent as a prerequisite to providing medical treatment.
The AMA Code of Conduct describes informed consent as a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved. This ordinarily involves clearly explaining the nature of the treatment, alternative options, and the material risks and benefits of both the treatment and the alternatives.
A Checklist to keep you protected
The following are some key points to assist you in regards to informed consent-
- Consider whether the proposed service is safe and clinically appropriate for telehealth, or whether a physical examination is necessary to provide good patient care.
- Clearly explain the limitations of the telehealth consultation model and any alternative methods of service. It is essential that the patient understands the risks associated and that they are involved in the shared-decision making process underpinning informed consent.
- Ensure the patient is informed of the alternative option of an in person consultation, either at your practice or at another practice, if this is clinically appropriate and safe for the patient, staff and the community.
- Verbal consent is generally sufficient for low risk, unrecorded video consultations but must be documented in the health records. However, written consent is safer for more significant procedures or consultations (e.g. psychotherapy) or where any part of the video consultation is to be recorded.
- Record the details of any other parties present during the consultation and the patient’s explicit consent for them to be present.
- Ensure that the patient is willing and able to sit in front of a camera and can adequately communicate because if communication fails it may not be possible to obtain informed consent.
- Ensure that the patient’s privacy and rights to confidentially are protected, particularly if working from home, and that this is sufficiently communicated to the patient in obtaining informed consent.
Tego Insurance Wants You To Be Vigilant
At Tego, we believe that it is critical that health care practitioners be aware of the limitations of telehealth.
As Medical indemnity insurance providers in Australia, we will cover your practice with medical indemnity insurance, medical malpractice insurance, doctors indemnity insurance, medical practice insurance, GP medical indemnity insurance, and more. If you are a medical practitioner with Tego, your medical indemnity insurance comes with 24/7 medico-legal advice and support to guide you through the risks of telehealth and informed consent.
This publication is general in nature and is not comprehensive or constitutes legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss suffered in connection with the use of this information.