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\n The regulator issued guidance this week which it says \u2018expands advice\u2019 for telehealth prescribers.
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\n News<\/p>\n
\n The regulator has flagged the need for a face-to-face consultation prior to prescribing, seemingly contradicting Medical Board guidelines.
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\n The regulator issued guidance this week which it says \u2018expands advice\u2019 for telehealth prescribers.
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\n Update: 6.30pm, Thursday 9 October: AHPRA has now amended its website and clarified that there has been no\u00a0change to the telehealth guidelines from the Medical Board of Australia.<\/p>\n
New telehealth guidance issued by the Australian Health Practitioner Regulation Agency (AHPRA) goes substantially beyond existing guidelines, advising that prescribing should only take place after a face-to-face consultation. In its announcement, AHPRA states that telehealth good practice constitutes \u2018only prescribing if you\u2019ve consulted with the patient face-to-face before\u2019.
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\nThe update issued on Tuesday<\/a>, which AHPRA described as \u2018consistent\u2019 with current Medical Board of Australia (MBA) guidelines, in fact goes notably further than the previously published document which came into effect in September 2023.<\/p>\n
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\nThe wording is substantially stronger than the current advice<\/a>, which includes the following:
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\n\u2018Prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board.\u2019
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\nThe newly issued advice has already caused speculation about the implications for online prescribing business models<\/a> that have mushroomed in recent years.
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\nWhen queried by newsGP about the difference, the regulator said definitions of\u00a0good practice help practitioners meet patients\u2019 needs and their own professional obligations.\u00a0
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\n\u2018It is informed by evidence and goes to a practitioner\u2019s clinical judgement,\u2019 an AHPRA spokesperson told newsGP.
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\n\u2018AHPRA continues to respond to concerns around prescribing via telehealth. When concerns arise, practitioners are asked to provide further information about how they exercise their clinical judgement to meet the patient\u2019s needs and their own professional obligations.\u00a0\u00a0\u00a0\u00a0
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\n\u2018While face-to-face consultations before prescribing remain best practice, there may be circumstances in which a practitioner can demonstrate that an alternative approach to that broadly defined as \u201cgood practice\u201d is, in their professional judgement, appropriate and safe.\u2019\u00a0
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\nThe update issued by the regulator \u2018confirms there are the same expectations for all practitioners when providing safe and effective telehealth services\u2019.
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\nIt was released against the backdrop of widespread concern about the impact of so-called \u2018vertically integrated clinics,\u2019 particularly for medicinal cannabis, and includes several case studies highlighting poor practice in that field.
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\nPrescribing and dispensing rates of high-strength tetrahydrocannabinol have skyrocketed in recent years. Last month, AHPRA issued new advice for pharmacists<\/a> supplying medicinal cannabis products, having issued new guidelines<\/a>\u00a0for prescribers in July.
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\nBoth prescribers and dispensers are warned to be \u2018as careful and diligent\u2019 with the prescription and supply of medicinal cannabis as they would be with other drugs of dependence.
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\nAHPRA also flagged concerns over emergency department presentations showing medicinal cannabis-induced psychosis as well as \u2018evidence of over-servicing and ethical grey areas around single-purpose dispensaries\u2019.
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\nIn the advice issued this week, AHPRA repeatedly stresses that the onus is on individual health practitioners rather than their employers to justify their clinical decisions.
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\n\u2018Practitioners working in telehealth-only clinics, particularly those focused on single treatments or medicines, are encouraged to review the clinical governance framework to ensure the care they provide isn\u2019t compromised by commercial gain or convenience,\u2019 it said.\u00a0
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\nFollowing the release of the update, and AHPRA\u2019s response to the difference from current guidelines, newsGP asked medical indemnity organisations Avant and MDA National for their view on any implications for GPs working under telehealth business models.
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\nAvant was unable to comment in time for publication, while MDA National declined to comment. \u00a0
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\nThe MBA guidelines remain current, with a review scheduled \u2018from time to time as required\u2019.
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\n\u2018This will generally be at least every five years,\u2019 the document states.
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\nAccording to the Australian Bureau of Statistics<\/a>, 23.6% of the population had a telehealth consultation in 2023\u201324, including 19.7% with a GP.
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\nAHPRA says the growth in telehealth services has been accompanied by an increase in related notifications, which climbed to 586 in 2024\u201325.\u00a0
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\n AHPRA<\/a> medicinal cannabis prescribing<\/a> telehealth<\/a>
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