Technology-based patient consultations - 2013

Technology-based patient consultations are increasingly being used by all medical specialties. 

Technology-based patient consultations are defined by the Medical Board of Australia as:

patient consultations that use any form of technology, including, but not restricted to videoconferencing, internet and telephone, as an alternative to face-to-face consultations.

Technology-based patient consultations are an appropriate alternative to consulting with a patient in the same physical room when they are used:

• as an adjunct to normal medical practice;
• for regular patients of the practice;
• for patients who have been referred by another medical practitioner;
• when it is clinically appropriate for the patient’s circumstances.

Used in this way, technology-based patient consultations can improve patient access to care and can enhance efficiency in medical practice.  They complement but do not replace face-to-face consultations, which enable a physical examination of the patient as part of the therapeutic process.  Technology-based patient consultations should not be used in a way that fragments the ongoing care and management of the patient.

When providing a technology-based patient consultation, a medical practitioner should be confident that:

• the consultation occurs in a private and secure environment to protect patient privacy;
• the patient is properly identified before commencing the consultation;
• the patient understands and agrees the arrangements for technology-based consultations;
• the practitioner reviews the patient’s file and makes a clinical record as they would do in a face-to-face consultation; and
• the patient is informed about costs and billing arrangements for technology-based consultations.

As with face-to-face consultations, medical fees for technology-based patient consultations should include the indirect costs of providing the service such as:

• the scheduling of appointments (for the practitioner and the patient to be available at the same pre-determined time);
• secure IT infrastructure, and telephone and/or data lines;  
• electronic billing arrangements; and
• arranging follow up services for the patient.

As a medical service, it is appropriate that Medicare Benefits arrangements assist patients with the costs of medical care provided using technology-based patient consultations.