After-hours telemedicine, why, what reason, qualifications, etc

Introduction

Driven in part by the COVID-19 pandemic, telehealth services have rapidly grown as a comprehensive option for accessing health care, in particular after-hours. Since January 2022, telehealth has also become a more permanent and integral, Medicare-supported part of the Australian health care system. Telemedicine is here to stay. This gives you greater access to qualified care, often with shorter wait times, longer opening hours, and competitive pricing.

But owing to the sheer number of Australian telehealth providers available online, it can be hard to know what to look for. This article will help shed some light on what factors you should consider.

There can be several drivers, including a busy schedule, quick need for urgent care, and, for example, symptoms like fever spiking with the immune system’s heightened response in the evening – any parent with a young child will have seen the alarming rise in temperature around dinner time… Sometimes, telehealth can be your best (or first) option. Here’s why:

• Efficiency: The patient can keep resting at home right up to the appointment time. You can get a faster and more timely initial assessment, allowing you to start medication or head to an A&E if required, or have peace of mind, if not.
• Less Hassle: No need to ring around doctors’ clinics, wait for the home doctor to come, or head to your nearest A&E straight away. Reduced travel and wait time with priority services often being available within 15 minutes.
• Peace of Mind: You can contact a doctor early on in your illness, ask about warning signs for worsening, start medication timely, and be assured that you will be told if you need more urgent care. Knowing that the doctor, including paediatric specialists or other specialties, is just a phone call away with minimal wait time also means you can have the patient rest at home with less concern.

• Qualifications: All telehealth services in Australia use healthcare professionals registered with the Australian Medical Board [2]. The providers generally state on their website whether they use AHPRA-registered nurses, doctors (or a mix of both), qualified and registered General Practitioners (GPs), or Emergency Specialist Doctors. While nurses can provide some services, they do not have the same level of education and experience as a doctor. GPs have qualified in more specialised family practice and are registered with the Royal Australian College of General Practitioners [3].
• Regulations: Several governing bodies in Australia regulate telehealth services. These include the Medical Board of Australia [5], Digital Health Agency [6], AHPRA [4], and the RACGP [3]. This high level of oversight means online health services and virtual doctors’ consultations are subject to relatively high scrutiny.
• Services: Telehealth providers can offer video and phone consultations to help the doctor assess your symptoms. They may also ask you to complete an online questionnaire and ask questions about your medical history. They cannot, however, examine you physically, meaning they may lack important information for more severe or urgent illnesses. This means they may be a good first point of call, but cannot address prolonged or more serious conditions. They also do not offer the same continuity of care as your primary physician, but can share your medical records with your GP on your request.

• Check the opening hours, as not all services offer genuine 24/7 consultations. A lot of them have extended hours with a break from around midnight until 7 am or so, and some only open 8 am to 8 pm. These may not be suitable if you want to have the option for a follow-up call during the night, if necessary.
• Check wait times and availability of priority services to ensure you receive the fastest care. Some providers offer consultations within minutes, others within hours, and some may take a day or more to respond. While shorter wait times can cost a little more with some providers, others do not charge for the faster service.
• If cost is a consideration, check for bulk-billing providers and make sure you pay attention to wording such as “from $xyz”, as that often means longer or after-hour consults are charged at a higher rate.
• Qualifications can make a difference, in particular if you are calling on behalf of a family member. If you can speak to a GP or specialist, this may get you a more reliable diagnosis and better ongoing care.
• Medication delivery may be a consideration if you are choosing telehealth for convenience. Of course, heading out to fill a script at the nearest pharmacy is often your fastest option. But if you are too ill, living remotely, or caring for a sick relative, it may be best to choose an option with quick delivery or check on your closest night pharmacy with delivery options.

To get the most out of your appointment, here’s what to have on hand:

• Medicare Card.
• Write down a list of symptoms and timings, so you do not forget anything.
• Any medication you are currently taking, including dosage and when you first started taking it.
• Any allergies you have, especially to medication.
• Previous medical history, if relevant. This could include the last time you had similar symptoms, any underlying autoimmune diseases, or recurring bouts of illness in the recent past.

• Make sure you ask any questions you may have straight away.
• Write down any advice the doctor gives.
• Understand medication timing and dosage.
• Ask when your symptoms should improve.
• Check when you should call back or seek urgent medical care, if appropriate.
• Carefully look over any script to ensure your details, the doctor’s details, and the medication discussed are correctly stated.

Choosing the right telehealth provider is a little like choosing the right GP clinic. You may want to ask friends and family for referrals, check out online user review sites such as TrustPilot or ProductReview, and read MediCompare’s detailed provider reviews before booking.

Please note that all information provided is independently researched and fact-checked, but does not represent medical advice. Telehealth services are designed to complement, not replace, the care of your primary care physician. Please always check with your GP if you have any medical questions or if your condition does not improve.

[1] https://www.health.gov.au/topics/health-technologies-and-digital-health/about/telehealth
[2] https://www.ahpra.gov.au/sitecore/content/Medical/News/2023-09-01-Revised-telehealth-guidelines-now-in-effect.aspx
[3] https://www.racgp.org.au/the-racgp/about-us/about-the-racgp
[4] https://www.ahpra.gov.au/sitecore/content/Medical/News/2023-09-01-Revised-telehealth-guidelines-now-in-effect.aspx
[5] https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Telehealth-consultations-with-patients.aspx
[6] www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/digital-health-standards/digital-health-standards-guidelines/get-started/5-standards-for-systems-and-technologies/telehealth-services