Allowances should be made for the limitations imposed by telehealth media, particularly phones, on communication quality, which can suffer because of these limitations, degrade a provider’ s diagnostic capacity, quality of rapport and capacity for client engagement. They can also decrease the capacity to ensure that treatment plans are effectively communicated. For this reason, providers should carefully assess the purpose of any telehealth consultation, before and during the consultation, to ensure the selected mode of delivery is appropriate, is safe and meets the needs of the client. In addition, treatment plans and medication directions should be conveyed to the client in writing as well as verbally.
Because of the potentially significant clinical risk posed here, providers should be prepared to cease any telehealth consultation if or when it becomes obvious that a face-to-face consultation is necessary, and processes should be in place to facilitate this in a timely manner.
Security risks primarily involve unauthorised access to a client’ s personal information. Some of the steps that can be taken to mitigate risk here include ensuring that:
• only authorised persons( usually just the provider and the client) are within hearing / viewing distance of the consultation. To facilitate this it’ s useful to ask the client to confirm who’ s present at the other end of the conversation, and make a note of this in the client’ s file
• communication at both ends is only to be made from within private, secure and controlled spaces
• clients aren’ t recording the consultation without the provider’ s approval, or if the provider is recording the consultation, that this is only done after receiving the client’ s informed consent for this to occur
• audiovisual platforms are secure, noting that some are more secure than others- Microsoft Teams, for example, appears to have good security and appears to be the preferred platform for many Australian state and federal government agencies
• where audiovisual communication is used, the selected platform is secure and compliant with Australian privacy laws. Where these factors can’ t be confirmed, communication by phone may be preferable
• the audiovisual platform used has endto-end encryption, file encryption for any files that may need to be shared, is one where the platform doesn’ t have access to client conversations, and has a free version that can be used by clients
• the platform that’ s used only stores its data in Australia. Where data is stored will normally be set out in
the telecommunications platform’ s privacy policy, and if data is stored overseas it may not comply with Australian privacy laws
• where audiovisual communication is used, that access at both ends is protected by usernames and passwords at a minimum, but preferably with multi-factor authentication
• a data breach action plan is in place and that those who need to be are competent in its use
• where telehealth is used, the privacy practices that relate to this are clearly outlined in the clinic privacy policy on the provider’ s clinic website
For more on this see:
• The Australian government’ s Guide to Securing Personal Information at https:// www. oaic. gov. au / privacy / guidance-and-advice / guide-tosecuring-personal-information / and the Medical Benefit Scheme’ s telehealth Privacy Checklist at https:// www. mbsonline. gov. au / internet / mbsonline / publishing. nsf / Content / Factsheet- TelehealthPrivChecklist
• The Australian Medical Indemnity Protection Society’ s telehealth guide at https:// support. mips. com. au / home / telehealth-and-practicerisks-guide
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