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Expanded telehealth items for GPs


newsGP writers


23/03/2020 2:21:11 PM

Vulnerable GPs can now use telehealth for all consultations with all their patients amid the ongoing coronavirus outbreak.

Greg Hunt
Federal Health Minister Greg Hunt

Joint statement from Federal Health Minister Greg Hunt MP, AMA President Dr Tony Bartone, RACGP President Dr Harry Nespolon, and Principal Medical Advisor to the Department of Health Professor Michael Kidd.
 
We thank and acknowledge all of Australia’s vital healthcare workers for their ongoing commitment and dedication to providing Australians with the healthcare they need during this unprecedented time.
 
The Government has been consulting extensively with the Australian Medical Association (AMA), RACGP, Australian College of Rural and Remote Medicine (ACCRM), Rural Doctors Association of Australia (RDAA), and other key peak bodies and members of the medical profession and health professions to ensure Medicare is responsive to the challenges of COVID-19.
 
Amendments to Medicare are being implemented quickly, but also in a staged and proportionate way to ensure critical health services can continue to operate, and the integrity of our health system is maintained.
 
The Government is also consulting with the AMA, RACGP, ACCRM, RDAA, and other critical parts of the medical profession during the course of this week to further expand our telehealth response.
 
The co-design will look to the best practise expansion of telehealth items for all patients, with or without COVID-19, to see any GP or medical specialist during the COVID-19 health emergency.
 
From today, the Government will enable all vulnerable GPs and other vulnerable health professionals who are currently authorised to use telehealth item numbers to use telehealth for all consultations with all their patients.
 
This includes healthcare providers who are:

  • aged at least 70 years old
  • indigenous and aged at least 50 years old
  • pregnant
  • a parent of a child under 12 months
  • immune compromised.
  • have a chronic medical condition that results in increased risk from coronavirus infection.
This change will help protect the most vulnerable members of our healthcare workforce, while allowing them to continue to provide much needed medical care and advice to their patients.
 
It builds on a series of changes the Government has made in recent weeks, to create a more responsive and flexible Medicare system that meets the needs of patients and providers during this crisis.
 
It is expected a more comprehensive telehealth whole-of-population model of care and the detail of telehealth operations via phone and video will be confirmed by the end of this week as Stage four. This will include mental health and allied health consultations.
 
It is important that this is done carefully to ensure these new items do not have unintended adverse consequences for patients or the health system, while allowing GPs and medical specialists to continue to work during the pandemic, using phone and video where clinically appropriate.
 
We recognise telehealth is not appropriate for the management of all health care problems and in many cases face-to-face consultations will still be needed. It is imperative Australians continue to receive the high-quality medical care and advice they expect and deserve from their health-care providers. We cannot risk a reduction in the standard of medical care provided to the people of Australia.
 
We emphasise the importance of using telehealth item numbers responsibly, appropriately and for the right reasons during this pandemic. For details on when telehealth items can be used, please consult www.mbsonline.gov.au
 
This is new territory for many healthcare providers, who want to meet the challenges of providing healthcare during this medical crisis.
 
Many important questions and challenges have been raised, and we continue to work through these. We will continue to communicate changes on the Government website, with regular webinar updates listed online, and through peak bodies.
 
STAGE COVID-19 MBS telehealth Items
Stage 1
13 March
  • The Government began progressively opening access under the Medicare Benefits Schedule to telehealth for many consultations between patients and their GPs, mental health providers and medical specialists, where patients or GPs were required to self-isolate, or patients were considered vulnerable
Stage 2
WC 16 March
  • Expansion of MBS telehealth items for midwives and recognise a general practice for continuity of care practises (rather than an individual GP)
Stage 3 – CURRENT STATUS
WC 23 March
  • From today, the Government will allow all vulnerable GPs and other vulnerable health professionals who are currently authorised to use telehealth item numbers to use telehealth for all consultations with all their patients. This includes health care providers who are:
  • aged at least 70 years old
  • Indigenous and aged at least 50 years old
  • pregnant
  • a parent of a child under 12 months
  • immune compromised
  • have a chronic medical condition that results in increased risk from coronavirus infection.
Stage 4
Moving towards
  • The Government is consulting with the AMA, RACGP ACRRM, RDAA to co-design stage four of our telehealth whole of population response. The co-design will look to the best practise expansion of telehealth items for all patients, with or without COVID-19, to see GP, medical specialist, mental health or allied health professional during the COVID-19 health emergencyCGP ACRRM, RDAA to co-design stage four of our telehealth whole of population response. The co-design will look to the best practise expansion of telehealth items for all patients, with or without COVID-19, to see GP, medical specialist, mental health or allied health professional during the COVID-19 health emergency

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Dr Nadir Mohammad Nahem   24/03/2020 6:56:38 AM

This is a very good news for vulnerable GPS, but aren’t we all vulnerable?
This should apply for most if not all as it’s important to have some direct contact with patients at times. I know one would say that we’re rewarded for seeing patients but at the same time , we are at high risk of contracting COVID19 with lack of PPE and masks.


D   24/03/2020 7:44:34 AM

who makes the call to say whether a GP is immunocompromised or has a chronic condition? I have HTN (not treated with ACE/ARB) and mixed connective tissue disorder. I stopped my methotrexate 3 weeks ago because i did not want to put myself at increased risk.


Dr Duncan MacWalter   24/03/2020 8:27:40 AM

I don't know who thought it would be a good idea to link the patient rebate to the providers age/health or ethnicity. This would be clear pay discrimination if MBS wasn't actually the patient insurer rather than our employer.
It seems a very dangerous, and unnecessary, precedent to make.


Dr Muhammad Jahangir   24/03/2020 9:11:35 AM

Make it possible for all GPS please, otherwise this plan will divert patients to so called " Non vulnerable " doctors and if some one gets the virus, how would you defend your policy....


Dr Janaka Abeysirigunawardana   24/03/2020 11:01:55 AM

I have been using telephone consulting for last one week to address health needs of my regular patients(while I am self isolated after arriving from overseas). I found this very helpful for my patients who could get there regular medications, address their health concerns during this time when there are many uncertainties about the way they should act and concerns on health of their loved family members, without attending the clinic avoiding the risk of unnecessary exposure, I also manged to direct a high risk patient (satisfying suspected case definition) to COVID testing. The patient's are very happy of the service although it limits ability for physical examination for which you could advise attending to clinic if indicated. I feel the teleconsulting should be extended to all GPs to provide care to all of their regular patients during this vulnerable period.


Dr Matthew Kieron Ramsay Edwards   24/03/2020 11:43:07 AM

We need to be able to do Telehealth Consults for ALL patients ASAP!
As it stands somebody rings with respiratory symptoms, and in the vast majority of cases we have no choice but to bring them to the surgery, past other people, possibly on public transport, to sit near other, often unwell patients, just to tell them to go home and self-isolate!!
This is illogical madness and must change immediately.
If the RACGP are not already doing so (and I pray you are) they must press the government to change this stupid and dangerous rule ASAP, for the patients benefit, ours, and society as a whole.


Dr Michelle Celeste Skellern   24/03/2020 1:07:48 PM

What about GPs who are living with a vulnerable person? I live with my elderly mother and she has nowhere else to lock down away from me. She is a vulnerable person > 70 years. Can I not then also be able to telehealth all my patients under this circumstance?


Dr Manju Salaria   24/03/2020 7:56:53 PM

This definition of vulnerable GP is very confusing. How can we make it for all GPs? Even the reception staff at the front desk is not comfortable with the face to face meeting with the respiratory patient. I think it should be done immediately for at least 3 months and then can be reviewed later.


Dr John Darcy O'Donnell   24/03/2020 11:59:50 PM

For all patients as soon as possible!


Dr Joseph Sous   29/03/2020 5:37:13 PM

I propose in the view of the Corona virus pandemic that the department of health should review the need for a DPA categorisation map
As all the country as a whole is considered a DPA (DWS) in the case of the pandemic, especially the most crowded cities in Australia.
And I urge my fellow GPs to support this proposal so that more health care providers can be in the frontline and available for patients