Part of facilitating safe and convenient consultations is keeping practitioners informed of the current trends and requirements around Telehealth in South Africa. To provide a bit more clarity on the topic, we have compiled a guideline to best practice and ethical considerations for video consultations.
What is Telehealth?
As defined by the Healthcare Practitioners Council of South Africa (HPCSA), “Telehealth involves secure video conferencing, or similar forms of technology, which enable healthcare practitioners to replicate the interaction of traditional face-to-face consultations between healthcare practitioners and the patient.”. It also refers to the sharing of information via online or offline sources.
Ollie Health’s video platform is fully compliant with HIPAA standards of video conferencing security. Our unique one-click links are safe, and private.
What are HPCSA stipulations on Telehealth?
In April 2020, the HPCSA updated its regulations to stipulate that, under the State of Disaster, Telehealth consultations are allowed when it is in the clinical best interests of a patient, with or without an already existing practitioner-patient relationship.
Will Telehealth consultations continue after the end of the Covid-19 pandemic? We at Ollie believe that they will. A growing global reliance on Telehealth to provide valuable care to underserved communities, and significant support from society indicates that Telehealth will remain significant in the industry for the foreseeable future.
How do I decide whether a virtual consultation is appropriate?
Telehealth consults should only be undertaken if it is possible to adequately assess the patient in this way. If at any point in time during the consultation, you, as a practitioner, cannot provide the best care for the patient, you should recommend they visit their closest healthcare facility for a physical assessment. Delivering the best care is determined by the discretion of the practitioner and governed by the general ethical considerations laid out by the HPCSA.
We have found, however, that patients are also pretty good determinants of when a video consultation will be sufficient in treating their complaint.
Do I need to request specific consent for a virtual consultation?
Yes. We issue practitioners listed with us a link to a Google form, which should be completed by patients before or during a telehealth session. This form has been modelled off of the South African Medical Association's (SAMA) recommendations and integrated with international guidelines.
Should I bill differently for a virtual consultation?
Despite the benefits of Telehealth, there are limitations to the capabilities of technology in comprehensively treating a patient, such as the inability to perform a physical assessment, for example. So, how should patients be charged for this new and unique way of being treated? Ollie Health maintains that it is up to the practitioner how they wish to charge for their services.
The South African Medical Association recommends the following:
A video consultation cannot be equated to with a visit in the rooms, so codes 0190 - 0193 are not applicable to video consultations. This is due to the fact that it is impossible to deliver the same quality of service as is possible in the rooms, where a physical assessment, injection or other clinical examination can be performed.
Instead, the following codes should be billed:
0130 - Consultation by means of a telephone of video platform (all hours)
0132 - “Consulting service”, for example, writing of repeat scripts or requesting routine pre-authorisation without the physical presence of the patient (needs not be face-to-face contact) (“Consultation” via SMS or electronic media included)
0133 - writing of any special motivations demanded by the Medical Scheme, without the presence of the patient. This includes issuing a clinical report on the patient.
Normal diagnosis (ICD10) codes will apply, with the addition of Covid-19 screening and observation coding.
The Ollie team is here to help 🤗
As we navigate the complexities of increasing access to healthcare in South Africa, there will always be more questions to answer, so this document will be updated regularly to reflect the most up-to-date insights. If you feel you need more clarity on any topic of telehealth, please don’t hesitate to reach out.
Healthcare has a distribution problem, we aim to accelerate closing the gap between patients in need and reliable care. Every South African deserves access to healthcare. If you have feedback on our service, or are looking to partner with our team to help us on our mission, please, feel free to reach out directly: firstname.lastname@example.org.
Please kindly note that these recommendations should be used as a guide only, and it is the sole responsibility of the practitioner to ensure that the ethics of their profession are upheld at all times.