Telehealth in psychiatry

What is telehealth in psychiatry?

Telehealth is a consultation between a patient and a psychiatrist conducted via video-conference or by telephone.

Provided here are resources for psychiatrists using telehealth in their practice, including information on setting up a telehealth system.

Why use telehealth?

Telehealth can greatly improve access to psychiatric services for people in rural and remote areas, and in other situations where face-to-face consultations are impracticable.

A number of studies have demonstrated that telehealth can be as effective as face-to-face consultations in achieving improved health outcomes.

Implementing telepsychiatry requires a planned and coordinated approach, but the technical set-up need not be difficult or expensive.

In Australia, Medicare rebates are available for telehealth consultations.

Professional standards

These documents outline the standards expected of doctors practising in Australia and Aotearoa New Zealand. They apply to doctors registered in Australia and Aotearoa New Zealand who practise telehealth, as well as to doctors registered overseas who provide telehealth services to patients in Australia or New Zealand.

Setting up and using telehealth in psychiatry

The RANZCP has produced the following resource to help psychiatrists implement telepsychiatry:

Technical specifications for telepsychiatry [PDF; 480 KB]

New Zealand-based psychiatrists can refer to information from the New Zealand Telehealth Resource Centre and the Te Whatu Ora (Health New Zealand) Digital health webpage, which provide advice on protocols, guidelines and standards for Aotearoan New Zealand practitioners.

Maintaining privacy and confidentiality is critical when undertaking consultations by telehealth in psychiatry. Psychiatrists should familiarise themselves with privacy principles in Australia and Aotearoa New Zealand, noting that the requirements are the same as for face-to-face consultations. The Australian Government Department of Health has developed a privacy checklist for telehealth services.

The RANZCP also recommends reviewing information available from your medical indemnity insurer about undertaking consultations by telehealth in psychiatry, as some insurers have developed policies in this area.

E-learning

Setting up a telehealth environment for psychiatrists (e-learning module)
Professional practice standards and guides for telepsychiatry (e-learning module)

Presentations and webinars

Implementing practical telehealth in psychiatry - Professor Richard Harvey and Dr Cybele Dey (22 April 2020)

Patient information

The RANZCP has produced the following resources for patients who use telehealth in psychiatry.

Seeing a psychiatrist online [Fact sheet for patients]
Setting up a telehealth environment when consulting with your psychiatrist from home [e-learning module]

Medicare and telehealth

In Australia Medicare Benefits Schedule (MBS) items allow for the funded delivery of psychiatry services via telehealth.

For descriptions of these MBS items, please refer to MBS Online. For further information on MBS items, please contact askmbs@humanservices.gov.au.

Following the introduction of the current telehealth MBS items on 1 January 2022 the RANZCP is liaising with the Australian Government to ensure that the MBS item numbers for telehealth adequately support people who face issues of affordable access to treatment, including in regional and rural areas.

On 1 November 2022, MBS item 294 was introduced to apply a 50 per cent fee loading to bulk billed psychiatry attendances delivered by video telehealth to regional and rural patients, care recipients of residential aged care facilities and patients of Aboriginal Medical Services and Aboriginal Community Controlled Health Services. The introduction of MBS item 294 will replicate the former fee loading item 288.

The Australian Government Department of Health and Aged Care has provided a fact sheet on ‘Fee loading for bulk billed consultant psychiatrist telehealth attendance – New MBS item 294’. Please refer to the fact sheet for further information.

Medicare has advised that, when using telehealth internationally, both the provider and the patient need to be located within Australia for benefits to be payable. Whilst it is possible to continue to provide this service, it would have to be billed privately. Information about using telehealth internationally is available in Medical Board of Australia: Telehealth consultations with patients.

Under the Pharmaceutical Benefits Scheme (PBS), psychiatrists are similarly considered ‘PBS prescribers’ as per Part VII of the National Health Act 1953 only when practising from within Australia or eligible external territories listed in Section 6A. PBS prescriptions issued from overseas are invalid for the purpose of benefits a patient would otherwise be entitled to under Section 89 of the Act.

Contact

policy@ranzcp.org