Notice: Sunday 22 March. We are rapidly developing guidance and materials for providers to assist in their quick transition to telehealth. This page may be empty or incomplete. Our team is hard at work and will be making regular updates.
The healthcare system in New Zealand will face significant pressures due to the Covid-19 outbreak. We will need to work in different ways from usual, so to support this, the following advice sets out some of the general guidance on using telehealth in New Zealand at this time.
Health providers should first seek guidance from within their organisation. Most District Health Boards have some telehealth capability and are working with haste to expand this. Primary healthcare providers should seek advice and support from their Primary Health Organisation (PHO). Again many are rapidly developing guidance on telehealth.
All health professionals should be aware of and consider regulations, standards and guidelines from their professional bodies. A comprehensive listing of these is available here.
The overarching principle is that all health providers should use their clinical judgement to decide if the telehealth consultation is clinically appropriate. If the telehealth quality is poor, and a phone consultation is inadequate, or if a physical examination is required, then an in-person appointment should be made. If any significant wellbeing or safety, concerns arise during the consultation escalate these as per your usual protocol.
You should safeguard personal/confidential patient information in the same way you would with any other consultation.
The consent of the patient or service user is implied by them accepting the invite and entering the consultation. However,
good practice would be to confirm this on commencing. Remember to confirm patient identity before progressing the
Use a phone or video consultation as much as possible
A health professional does not always need to see a patient in-person providing it is clinically appropriate. Wherever possible, a telephone or video consultation should be considered for these interactions. Some clinicians may also choose to utilise secure email. The focus should be on what information you share and who you share it with, rather than how you share it.
Remember this form of consultation will be new for many. Take the time to discuss with your patient if they feel comfortable with this approach.
Benefits and scenarios for telehealth
In the best of times, telehealth reduces unnecessary travel and efficiently provides quality care irrespective of a patient’s or clinician’s location. These benefits can and should be leveraged to help fight the spread of COVID-19. Telehealth is a critical way that providers can reduce risk while maintaining close relationships with their patients.
Some examples include:
- people accessing essential health services from their home, for example, all GP consultations should be conducted by phone, video or secure email unless there is a clear need for a physical examination or procedure that can only be done at a clinic
- a follow-up appointment with a specialist, or an appointment with allied health professionals
- our vulnerable population accessing health services with reduced risk of exposure, for example, patients with underlying medical conditions or the elderly accessing health services
- health professionals continuing to provide health services from their home while they undergo self-isolation.
There is a very high acceptance from patients that have participated in a telehealth consultation, and it is unusual for patients to decline a consultation by telehealth once given the option. In a recent study by Waitemata DHB, over 88% of patients said they would book more telehealth appointments in the future.
Waikato DHB research found similarly high levels of support from Maori whanau.
Many health consumers, however, are new to telehealth, so there is significant work that must be undertaken to make consumers aware of telehealth, and they must be provided with very clear instructions. Many organisations, including www.telehealth.org.nz and www.healthnavigator.org.nz are rapidly developing resources.
Up to 20% of the population, however, will not have access or skills to embrace telehealth, and this percentage may be higher for our high needs population. Work is underway to identify and remove some of these barriers. In the interim, it is essential to start providing these services to those that are willing and able.
Patients should expect to be charged the same as for an equivalent in-person consultation.
Recording of video consultations by any party should only occur by mutual consent. Additional guidance on this will be
A lot of patience is required during any change. Please be mindful of this and carefully support staff and patients as they adapt to these changes. Consider starting with phone and email and then step into using video solutions. We recommend providers become familiar with the technology available and start small. Practice within your organisation before starting a pilot with a small number of patients.