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Telehealth

Last updated October 3, 2023

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Video and telephone consultations - collectively, “telehealth” - help protect both patients and providers, preventing the spread of infection.

MBS Online advises that "Videoconference services are the preferred approach for substituting a face-to-face consultation. However, in response to the COVID-19 pandemic, providers can also offer audio-only services via telephone if video is not available".

Telehealth enables GPs and other health providers to see patients remotely, so that people with symptoms can self-isolate. It is particularly helpful for patients with mobility issues as well as people in remote areas.

Download the PHN Telehealth Guide or PHN Telehealth Guide for RACFs now.

The PHN in partnership with Brennan IT, have setup a dedicated Help Desk to troubleshoot and resolve any issues while Telehealth consultations are being conducted.

By contacting this dedicated Help Desk the support personnel can identify the nature or cause of the issue and assist with remediation and, if necessary, work with your normal IT support to rectify certain issues.

How to contact:

Recommended video consultation system

Although many different video conference systems are available, the PHN supports the use of one video consultation system across all health services.

The Commonwealth government has provided funding for healthdirect Video Call - a comprehensive, secure and reliable video consulting service which follows the Australian Government cyber security guidelines and safeguards privacy.

healthdirect Video Call is free for use by:

  • General Practitioners
  • Allied Health Professionals
  • Aboriginal Community Controlled Health Services (ACCHS)

Other video consultation platforms may store call details outside Australia, which may put clinicians at risk of breach of privacy legislation without informed patient consent. See our Telehealth software comparison for more information.

When using healthdirect Video Call, both patients and health professionals can be confident that all video, audio, chat and shared screen activity is between patients and clinicians only and is fully encrypted.

Get set up to provide video consultations to patients

Five step process to register to use healthdirect Video Call

Free and easy registration

Register now for free video conferencing setup

The PHN offers free setup for new healthdirect Video Call users.

For more information on setting up healthdirect VideoCall for your practice, or to register now, email telehealth@thephn.com.au

Best practice video consultations

Video consultations most closely replicate the face-to-face consultation experience, providing the highest possible standard of care.

Review the clinical processes described on the telehealth pages in the Hunter New England HealthPathways and Central Coast HealthPathways for pre-, during- and post-consultation activities.

To ensure a constructive and worthwhile consultation, make effort to maintain patient trust, communicate clearly and engage attentively with your patient.

Pre-consultation
Patient information

When booking a video consultation for a patient, make sure that you:

  • Provide patient with video consultation information and fee details, including any out-of-pocket costs.
  • Determine MBS telehealth item eligibility.
  • Confirm that the patient is able to participate in a video consultation.
  • Book a video consultation appointment, following our simple, one-page practice workflow guide.
  • Review patient records and reason for appointment.
  • Obtain informed financial consent.
Environment
  • Ensure you consult from a private location in which your consultations will not be seen, overheard or interrupted. The only people who should be able to hear your conversation are the video consultation participants.
  • Ensure you are well-lit - normal room lighting is usually sufficient.
  • Avoid sitting directly beneath the light source if possible. Side-lighting works well.
  • Be aware of incidental movement behind you. Ensure that you aren't sitting in front of a window to minimise distraction for participants.
Equipment
  • Familiarise yourself with the equipment and software before the consultation.
  • Understand what to do if things go wrong, and how to fix basic problems.
  • Know who to contact if you can't resolve any problems that do occur.
  • Charge and test your equipment before the call.
  • Run a test call or call a colleague to make sure everything works.
  • Be mindful of current audio and video settings.
Making the call from a desktop or laptop computer
  • Eliminate distractions and noises from your computer and surroundings, such as computer and mobile phone notifications.
  • Try to ensure that software updates do not occur during video consultations.
  • Only run the software you need to use while in the video call: this increases the resources available to your computer.
Set up the camera in a good position
  • Use a professional/neutral backdrop and good lighting.
  • Place the camera in a location where the participants stay within camera view.
  • Position your web camera so you are looking directly at the patient at eye level, if possible.
  • Keep the participants centred in the camera view.
Choose microphone and speakers based on location and environment
  • Laptop microphones and speakers are adequate but be aware of echo or feedback during conversations.
  • Headsets work well for single-person locations.
  • Use a noise-cancelling speakerphone device when multiple people are sharing the same room.
  • Position the microphone so that voices are clear and neither too loud nor soft.
During consultation
Getting started
  • Join the video call with your patient in the virtual consultation room.
  • Adjust your microphone and camera as required so that everyone can see and hear.
  • Introduce everyone attending the consultation.
  • Hold the consultation, applying the relevant professional standards, as you would normally.
Etiquette
  • Wear appropriate clothing - dress as you would when holding in-person consultations.
  • Wear neutral, muted solid colours where possible. Avoid patterns, stripes, dots, white and red, which can all cause distracting screen effects.
Be mindful of body language and behaviour
  • Remember that the other participants can see you - act like they're in the room with you.
  • Avoid raising your voice.
Have alternative contact information available
  • Be prepared to contact other participants by phone if something goes wrong with the video consultation.
Focus on the call
  • Assure your patient that they have your full attention, showing eye contact, positive body language and attentiveness.
  • Do not check your email or phone while in a video call.
  • Look at the camera when you talk, not at the screen.
Understand the subtle differences between meeting via video and meeting face-to-face
  • There is always a small amount of lag in conversations. Be patient and allow participants time to finish speaking.
  • Use the teach-back method to ensure patient understanding.
Post-consultation
  • When the call ends, ensure all video and audio equipment is switched off.
  • Check the patient understands the outcome of the consultation.
  • Update the patient record with your consultation notes as soon as possible.
  • Organise follow up and supplementary resources, information, education and links required.

Telehealth FAQs

Why offer video consultations in preference to telephone consultations?

Providing medical care via video conference improves patients’ access to care and helps to create a more sustainable health care system.

Being unable to see a patient means that practitioners must make decisions with less information than they would receive if they were conducting a face-to-face consultation.

Although physical examination is not possible in a video consultation, being able to see their patient provides health professionals with much more information than they receive when holding a telephone consultation.

For example, while people can sound positive over the telephone, in a video consultation, health professionals may observe signs of trauma, domestic violence, depression or anxiety through body language, reactions or physical wounds.

Video consultation provides greater opportunity for practitioners to observe these signs and symptoms, helping the to ensure that the patient receives a suitable and high-quality treatment.

What are the benefits of video consultation for health professionals?

Greater depth and detail - The Royal Australian College of General Practitioners reports that “the addition of visual images... adds value to any telehealth consultation and can improve both quality and safety”.

Non-verbal visual observations - Patients can communicate with practitioners non-verbally, through writing, signs, signals and body language.

Time savings - The British Medical Journal recently reported that video consultations save time, as (on average):

  • Video consultations were almost four minutes shorter than face-to-face consultations, and
  • Patients raised fewer problems than they did in face-to-face consultations.

Patient satisfaction - Australia’s Health Panel recently found that 83% of interviewees were likely to use - or would definitely use - telehealth services in the future.

In a HotDoc survey patients expressed their preference for telehealth appointments with their current GP, particularly for results, repeat prescriptions, specialist referral and follow-up appointments.

Meeting patient demand for video consultation is likely to increase satisfaction with the services offered by clinicians.

What are the benefits of video consultation for patients?
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I was more relaxed in my consultation. I was in my familiar environment and the specialist and I were both at ease. I didn’t have the stress of getting the two people I care for sorted before the 90 minute drive to the city hospital for this appointment. I saved money on fuel and parking fees. I didn’t have to sit in a full waiting room. I didn’t have to turn down work for that entire day because of the travel time and waiting room time blowouts. The benefits of telehealth are immense.

Time and cost savings - Patients save time and travel costs by attending the consultation at a location and time that is convenient for them.

The Consumers' Health Foundation of Australia reported that the Telehealth services survey found that over 80 per cent of people offered telehealth services used them, and a similar proportion viewed the service as being excellent or good quality.

Risk reduction - Particularly during the COVID-19 pandemic, when both patients and practitioners have heightened safety and security concerns, video consultation reduces risks and most closely replicates the face-to-face consultation experience, providing the highest possible standard of care.

What are the risks of not offering video consultation to patients?

It is important that practices and practitioners are aware of the MBS rules and stay on top of any changes.

(Refer to Hunter New England HealthPathways or Central Coast HealthPathways for more information).

Remember, when face-to-face consultations are not available, videoconference services are the preferred approach for substituting a face-to-face consultation.

If video is not available, health practitioners will also be able to offer audio-only services via telephone.

It is in patients’ best interests to have the most comprehensive consultation available, with the highest possible standard of care.

It is in practitioners’ best interests to minimise the risk of missing something in a triage or consultation without visual examination or the ability to observe body language and comprehension.

No practitioner wants to be in breach of the MBS guidelines, nor to run the risk of receiving an unfavourable audit, with the associated consequences.

Reduce your risk - supplement your existing service offering with video consultation to protect your practice and practitioners.

When are video, telephone and face-to-face consultations appropriate?

Although some issues can be managed through more than one type of consultation, video conference is the preferred approach for substituting a face-to-face consultation.

(Refer to Hunter New England HealthPathways or Central Coast HealthPathways for more information).

The table below provides guidance on which consultation type may best suit various scenarios, when face-to-face consultation is not available or desirable.

However, every health professional must exercise judgement about the appropriateness of video, telephone and/or face-to-face consultations, considering the clinical risks of each, as well as the risks of not conducting a consultation at all.

Situation Video Telephone Face-to-face
Any condition/ scenario where telehealth protects vulnerable people (e.g. older patients and patients with comorbidities who are at increased risk if they contract COVID-19) Yes
You are working remotely or self-isolating Yes
The patient has a family member or carer to support them Yes
The patient needs reassurance Yes
Chronic disease management, especially where the patient is fairly stable and has monitoring devices (if required) at home Yes
Repeat prescriptions Yes
Referral letters Yes
Exploring mental health issues Yes
Exploring diet and physical activity Yes
Skin conditions Yes
Relatively straightfoward clinical needs, short-term illnesses or treatment requests (e.g. straightforward urinary tract or upper respiratory tract infections) Yes
You have access to the patient’s records Yes
You can provide all the necessary advice or information verbally or electronically Yes
The patient has capacity to make decisions about their treatment Yes
Counselling services Yes
The patient needs to lip read Yes
The patient is from a non-English-speaking background Yes
The patient needs a translator Yes
The patient needs to see information (e.g. an instructional video, diagram or flowchart) Yes
The patient needs to provide images, videos, photos, diaries, progress reports, etc. Yes
Any consultation where the trade-off between attending in person and staying at home favours the latter Yes
The patient lacks adequate internet access Yes
The patient does not have access to a computer, tablet or mobile with a camera and microphone Yes
Potentially serious, high-risk conditions requiring physical examination, particularly patients with chronic disease who are unable to self-monitor appropriately and patients at high risk for poor outcomes from COVID-19 Yes
Internal examination is required and cannot be deferred to support clinical decision making Yes
The patient’s ability to communicate by telephone or video consultation is compromised and they do not have a support person to assist them during the consultation Yes
Situations where there is any doubt about the clinical appropriateness of a telephone or video consultation Yes
Conditions which require physical examination (e.g. listening to heart or lungs, feeling the abdomen, taking temperature) Yes
Procedures (e.g. excising skin lesions, taking swabs and smears, inserting contraceptive devices, giving injections) Yes
Checking blood pressure (if unable to be monitored remotely) Yes
Routine check-ups and screening tests (if unable to be postponed) Yes
You are not the patient’s usual GP or doctor Yes
You do not have access to the patient’s records Yes
The patient has not consented to a video consultation Yes
The patient has complex clinical needs or requests higher risk treatments Yes
You are unsure about the patient’s capacity to decide on their treatment Yes
It is difficult to determine by telehealth whether the patient has all the information about treatment options that they want and need Yes

These examples were sourced from this article by Dr Brett Montgomery, Senior Lecturer in General Practice at the University of Western Australia, these RACGP guidelines, the Royal Australasian College of Physicians Members’ Survey and the UK General Medical Council.

Call the National Coronavirus Helpline on 1800 020 080 for guidance on managing pre-screening for patients who may be at risk of COVID-19.

Visit the Australian Department of Health website for resources on managing patients who have tested positive to COVID-19, for health professionals (including aged care providers, pathology providers and healthcare managers).

Must I use healthdirect Video Call?

Health professionals are not obligated to use healthdirect Video Call, but must ensure that their chosen video consultation system meets clinical requirements and satisfies privacy laws.

To assist providers with their privacy obligations, a privacy checklist for telehealth services is available on MBS Online.

Always check video conferencing settings to ensure that:

  • There is no recording of your consultation,
  • Only the appropriate patient can join a consultation at the designated time, and
  • No patient can enter a consultation without the practitioner’s permission.

Use the resources below to ensure that your chosen video consultation system meets clinical requirements and satisfies privacy laws:

Can I use healthdirect Video Call on my phone?

Yes. Open a browser window and go to https://vcc.healthdirect.org.au/login.

Log in, and you will have access to the same features available through the web portal when it's used on a laptop or tablet.

Is video consultation private and secure?

The PHN recommends use of a secure and reliable video consultation service, such as healthdirect Video Call, which follows the Australian Government cyber security guidelines and safeguards privacy.

Both patients and health professionals can be confident that all video, audio, chat and shared screen activity during video consultation using healthdirect Video Call are between patients and clinicians only and are fully encrypted.

Assure patients that:

  • You will consult with them from a private place where you will not be overheard or interrupted (especially if consulting from home),
  • Their consultation details and treatment information will be recorded in your normal clinical system,
  • Any personal information you receive from the patient or obtain through a video or telephone consultation will be safely transferred to your normal clinical system, or deleted if not required, as soon as possible.

The use of video consultation does not impact or change the normal clinical obligations required of health professionals when engaging with patients, so:

  • Continue to use your existing practice management software for clinical notes,
  • Share these resources with your patient, and
  • Ensure you apply the relevant professional standards, as you would normally.
How do different video conference systems compare?

The PHN has compared the features, costs and security of commonly used video consultation systems in our Telehealth software comparison.

Email telehealth@thephn.com.au with the name of your current video conferencing system (if applicable). We’ll help you compare options, minimise risk and maximise security in video consultation.

What equipment do I need for video consultation?

In order to provide video consultations to patients, you will need the following equipment:

PHN technology provider Brennan IT can help you determine the most suitable products for your practice, and purchase what you need.

Call Brennan IT on 4969 0690 for advice and guidance on purchasing the right equipment for your business.

What browser should I use?

Use the latest version of Google Chrome or Safari for best quality video consultation.

Visit What’s my browser? to check your web browser and version (including whether it is the latest version available or not).

How do I install Google Chrome?

Visit the Google Chrome website and follow the instructions.

How do I know if I have the latest version of Google Chrome?

In the address bar, type: chrome://help/ and press Enter. This will open Chrome's “About” page. The text below the version number will indicate whether you have the current version.

If a newer version is available, Chrome may update automatically.

What does video consultation cost?

The cost of providing video consultations will vary depending on the system selected, equipment required, and other factors.

Video consultation can also save time and expenses such as travel, PPE (e.g. masks, gowns, gloves, etc.) and room and clinic space.

MBS telehealth items

The resources below will help you to understand what MBS items can be used for Telehealth, including recent additions.

If you are part of the Hunter, New England or Central Coast regions, you can also contact your Primary Care Improvement Officer (PCIO) for more information.

Video consultation system costs

Our Telehealth software comparison provides some information on the costs of software.

Information on the cost to use healthdirect Video Call once Federal funding ceases will be provided when it becomes available. Comparable video consultation systems that have been developed specifically for the health industry range from AUD$19.95 per month for Allied Health professionals to AUD$45.00 per month for GP users, and it is expected that healthdirect Video Call will be priced similarly.

How do I use video consultation appropriately?

We’ve prepared a simple, one-page summary of practice information and workflows to help you offer video consultations to patients. It outlines the simple steps to:

  • Implementing healthdirect Video Call in your practice,
  • How to book and commence a video consultation,
  • How to manage patients in the waiting room, and
  • What to do after the consultation.
Where do I get help to set up video consultation?

We’re here to help.

  • Users of healthdirect Video Call can access online resources and receive training directly from healthdirect Australia, free of charge.
  • We provide demonstrations of healthdirect Video Call to help GPs, AMS, Practice Managers, administrators and Allied Health professionals understand and become familiar with the features and functions.
  • We also offer free registration and setup for users - email telehealth@thephn.com.au to register now. We’ll set up your virtual clinic so you can log in and get started.
Will the PHN support healthdirect Video Call registration and setup on an ongoing basis?

Yes, the PHN will continue to provide free setup for users as long as healthdirect Australia permits.

How am I remunerated for providing services via telehealth?

Read the resources below to learn more about the telehealth MBS item numbers, including those that have recently been added.

How will my patients know video consultation is available?

A HotDoc survey found that patients who have had a telehealth appointment are much more likely to want to continue using telehealth.

However, the survey also found that 42 per cent of patients didn’t know (or weren’t sure) that their GP offered telehealth.

Make sure your patients know you provide video consultation by:

  • Making it a habit at the end of each consultation to notify patients that you offer video consultation, and explain which services are available,
  • Booking follow up appointments via video consultation (if it is suitable and the patient consents),
  • Promoting your video consultation offering:
    • In signage and information at your practice/facility
    • On your website, by adding a video call button using these instructions, if you use healthdirect Video Call
    • On your social media pages, and
    • Through SMS broadcasts
  • Sharing patient and practitioner video guides on your website or by email, and
  • Listing video consultation as the first appointment option on your website.
Can my patients use video consultation?

Most video conferencing systems are fairly simple and easy for patients to use. Many patients with a smart phone, tablet or laptop computer will be able to participate in a video consultation.

If you use healthdirect Video Call, your patients will not need to download anything. They will receive one link by SMS or email, which they click to join the consultation.

You might also like to:

  • Sign up for free training for your practice manager and administrators so they can support patients prior to and on the day of consultation,
  • Ask your patients whether a family member or carer can help them to participate in a video consultation,
  • Play this video for patients on the television in your waiting room,
  • Tailor this Patient Information Leaflet to your practice and give it to your patients, and
  • Share this guidance with your patients, to help them know what to do.
Can my patients’ needs be met by video consultation?

Review the services are available via video consultation and determine whether video consultation is suitable for the type of service required.

If it is, consider whether the patient has the equipment and ability to participate in a video consultation (with a carer or family member, if necessary).

Reassure your patient that video consultation will not be used if it is not suitable for their needs.

What is the process if the video consultation is delayed?

If the GP is running late, a practice administrator should notify the patient of the delay and if necessary, organise an alternative date and time.

If a patient needs to change the appointment date or time, they should inform the practice and request a revised appointment time for the video consultation.

Can I get a translator for my patient?

Yes. Organise an interpreter through the Translating & Interpreting Service.

Utilise these resources for consultations with people of non-English-speaking backgrounds.

Do patients need to consent to video consultation?

Patient consent is mandatory for video consultations.

Residential Aged Care Facilities (RACF) must maintain patient consent on residents’ records.

The NSW Civil & Administrative Tribunal (NCAT) Guardianship Division provides information on consent to medical treatment for people who lack capacity to consent for themselves.

What do I do if my patient gives me this hand signal?

All health professionals should be aware of the possibility that patients they consult with may be victims of domestic violence. Be aware that some patients may use this domestic violence hand signal to indicate they are in an unsafe situation and/or not able to talk freely.

If a patient gives you the domestic violence hand signal, do not respond verbally. Instead, acknowledge that you’ve received the message by nodding or signalling back with an ‘okay’ sign or thumbs up, and continue your conversation.

Once the consultation has ended, call the NSW Domestic Violence Line on 1800 656 463, or other appropriate services, to get help for your patient.

How will my patients know what rebates are available for telehealth consultations?

Give your patients the COVID-19 Telehealth Services Consumer Factsheet (MBS Online), and explain what rebates are available to them.

Is my internet service sufficient for video consultation?

To work smoothly, healthdirect Video Call requires a minimum broadband speed of 0.350 Mbps upstream and downstream.

Both you and your patients can check internet speed at Speedtest.net.

Close other applications on your phone or computer to maximise your video consultation.

What happens if I have a problem during video consultation?

Clinicians: Check the healthdirect troubleshooting guide to resolve any problems encountered during a video consultation, or try reconnecting to the consultation via the waiting room.

Patients: Check the healthdirect troubleshooting guide for patients or try reconnecting to the call by opening the link again.

Does video consultation change how prescriptions are delivered to pharmacies?

The COVID-19 Temporary MBS Telehealth Services Provider Frequently Asked Questions state that health professionals should mail or email a prescription to the patient or pharmacist.

RACGP guidance provides more detailed guidance on providing a pharmacy prescription following a telehealth consultation:

  • Print the prescription and sign it as per usual practice.
  • Create a digital copy of the signed prescription (a photo or pdf) and send the prescription via email, text or fax to the patient (use a practice email address/text message if possible).
  • Ask the patient if they would like the prescription sent directly to their pharmacy of choice and/or sent directly to them.
  • Send the digital prescription directly to the pharmacy and/or the patient via email, text or fax.
How do I find a GP, pharmacy or palliative care support service that is open after hours?

Call healthdirect on 1800 022 222. healthdirect is funded by the Federal, State and Territory Governments and provides trusted health information and advice online and over the phone, 24 hours a day, 7 days a week.

healthdirect provides the National Health Services Directory, which allows consumers to easily search for the closest doctor, pharmacy or other health service that is open now (including after hours).

NSW patients receiving palliative care, as well as their carers and families, can access a new service for additional advice and support during the after-hours period.

The NSW Palliative Care After Hours Helpline is a free service, available within NSW on weekdays from 5pm to 9am, on weekends and public holidays on 1800 548 225.

Telehealth Resources

Telehealth resources
General Practitioner resources
COVID-19 resources

Call the National Coronavirus Helpline on 1800 020 080 for information on coronavirus (COVID-19). The line operates 24 hours a day, seven days a week.

Telehealth resources
Allied Health professionals' resources
Resources for patients

COVID-19 resources

COVID-19 Telehealth Services Consumer Factsheet (MBSOnline)

Telehealth resources

If your patient may need assistance to participate in a video consultation, ask them whether a family member or carer can help them on the day, and share the following resources with them in advance.

healthdirect Video Call resources

To get the most out of a video consultation, advise your patients:

  • To attend from a quiet place, free of distractions,
  • Turn off television, radio and phone notifications,
  • Sit where they can be seen clearly (i.e. do not sit with their back to a window),
  • To close other applications on their phone or computer to optimise their video consultation,
  • To position their laptop/phone so it is stable and at eye level,
  • To be punctual, prepare in advance and login to their consultation (i.e. click the link provided) five minutes prior to their appointment time, and
  • To cancel or reschedule if they are unable to attend.
Resources for consultations with Aboriginal and Torres Strait Islander people

COVID-19 resources

Telehealth resources

Resources for consultations with people of Non-English Speaking Backgrounds
Resources for Residential Aged Care Facilities (RACF)

Appointments via video consultation are particularly useful for patients living in Residential Aged Care Facilities (RACF), who may have trouble getting out to appointments.

Video consultation provides patients with access to a GP when it might not otherwise be possible (e.g. during COVID-19, on a day the GP isn’t scheduled to visit, or when the resident is unwell).

Video consultations do not replace face-to-face consultations and not suitable for all appointments.

However, where suitable, video consultations offer benefits to GP and residents of RACF.

Resident / Residential Aged Care Facility General Practitioner
Less patient distress Sees the patient in their usual environment
Reduced waiting times and travel times Can access patients quickly and easily without needing to visit in person
Fewer hospital transfers
Easy for family and carers to participate
Increased access to GPs, Allied Health Professionals and Specialists
Can access patients quickly and easily without needing to visit in person

healthdirect Video Call education and training

Resources
Training
Webinars

Primary Care Quality Improvement Community of Practice Webinar #1 - Telehealth

Mastermind: Quality patient care via telehealth

COVID-19 Update #15 - Telehealth (from 20:52)

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