The COVID-19 pandemic has dominated our work and personal lives.  It has significantly changed healthcare.  The level of reform in just days and weeks is something which normally takes months and years.

An insight into the volume of change is in our COVID-19 medico-legal and insurance Q&A – www.miga.com.au/coronavirus.  This started in early March and has continued to expand and evolve frequently.

‘Whole of population’ Medicare telehealth, using protective equipment, changing scopes of practice, digital image prescribing, elective surgery, testing and treatment restrictions, and evolving certification needs are just some of the key changes we have seen for healthcare.

Throughout MIGA has been working closely with governments, regulators and professional organisations to ensure:

  • Change is sensible, practical and fair for frontline clinicians dealing with the day-to-day realities of healthcare during a pandemic
  • Improvements to healthcare delivery can continue.¹

Snapshots of some key issues and what they mean for you are below.

Telehealth 
MIGA believes the COVID-19 pandemic showed how telehealth can be used well.  It supports a broader Medicare telehealth model continuing into the future, for use where:

  • The profession considers it clinically appropriate
  • Patients are comfortable with it
  • It offers the same standard of care as a face-to-face consultation
  • Continuity of care is ensured, including ability to see the doctor or their colleague when needed.

We have also emphasised the need for privacy / security expectations on the profession, particularly around video platforms, to be realistic, and clarity in sometimes confusing and complex Medicare telehealth items.

Digital image prescribing
From late March, Australian Governments began to introduce digital image prescribing, allowing an image of a prescription to be sent to a pharmacist directly.

This was an important initiative, but with significant implementation issues.

After it was announced, there were delays in introducing regulation to legalise it.   This caused potential confusion and medico-legal risks for the profession.

MIGA has been advocating to ensure no doctor faces regulatory action for using this new model in good faith before it was legal in their state / territory.

It is pleasing to see South Australia and Queensland have retrospectively legalised these prescriptions.

Over the coming months, we will also see the introduction of electronic prescribing, using digital tokens / QR codes and ‘active script lists’.²

Remembering COVID-19 pressures in medico-legal processes
MIGA has been emphasising the need for regulators to recognise the realities of the pandemic.

A doctor attempting to provide the best care they could in difficult circumstances, under significant personal and professional pressure, should not be judged by unfair standards of best practice in ideal circumstances.

Importantly the Medical Board and AHPRA have recognised this issue, and we are advocating for it to be acknowledged in Medicare and other complaint / regulatory processes.

1 For more information on various COVID-19 advocacy issues across the country, you can read MIGA’s submissions to the Senate COVID-19 inquiry and to parliamentary inquiries in South Australia select COVID-19 Response Committee / Submissions) and Queensland 
2 More information on these models is available from the Australian Digital Health Agency 

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