Telehealth Requirements and ACC Guidlines
Telehealth is the use of information and video conferencing technologies to deliver health services to a patient and/or communicate health information regarding that patient.
Technology for using Telehealth
It is expected you will use platforms that have voice and video capabilities. Some of your patients may not have access to videoconferencing capable devices. During the COVID-19 response, ACC acknowledge that telephone consultations will reduce the ability to effectively manage patients and therefore it is expected to be used only where other avenues are not available to your patients.
Any device, software or service used for the purposes of telehealth must be secure and fit for purpose and must preserve the quality of the information or image being transmitted. Storage of information must be secure and remain onsite. Using platforms such as Skype, Zoom, Teams or other electronic record management systems requires additional strategies to maximise privacy and information security and this will be engaged by the practitioner.
You are expected to adhere to all Telehealth requirements and advice from the Ministry of Health including that as it relates to managing patients and reporting using Telehealth and online tools and will be guided by the advice provided for practitioners (via NZ Telehealth: https://www.telehealth.org.nz/covid-19/health-provider/) on how to implement remote consultations and what to expect including advice on security and technologies and providers in New Zealand for those seeking further assistance.
ACC requirements for using Telehealth
For all health professionals providing Telehealth consultations, you will need to make sure you can meet the following criteria:
- make sure the use of Telehealth is clinically appropriate
- complete a risk assessment and determine if Telehealth is a safe method of delivery. Your risk assessment may need to be continually reviewed
- provide an appropriate standard of service to our clients based on their clinical need
- make sure clients are within the TLA/region(s) specified in your contract
- obtain the client’s consent to provide services via Telehealth
- follow the Chiropractic Board’s guidelines and standards
- make sure Telehealth services are provided to a client living in New Zealand at the time of the consultation, by a provider who is living in New Zealand, at the time of the consultation
- use a Telehealth technology interface that meets the requirements outlined by the New Zealand Telehealth Resource Centre: NZ Telehealth COVID-19
It is important to inform and record the appointment appropriately within your notes including consent gained to use telehealth as outlined below.
You must clearly document the reason for, and method of telehealth used in your patient’s clinical record.
Please remember, if you provide this service, you must hold a current APC.
For Chiropractors aworking under the Cost of Treatment Regulations, Telehealth rates are paid as non-contracted codes based on the amount of time taken to provide services for initial and follow-up consultations under the Physiotherapy Services Contract. Please use the new billing codes in the table below:
|Service||Code||Rate (excl. GST)|
|Chiropractor Telehealth Initial||CHT1||$41.74|
|Chiropractor Telehealth Follow up||CHT||$29.47|
You will still need to consider the causation of the injury when completing the required forms.
Please read out the following statement to your patient and record your patient’s response in their clinical record:
1. Do you declare that you have provided true and correct information and you’ll tell ACC if your situation changes?
2. Do you authorise me as your (name of health profession: GP, physiotherapist, etc) to lodge your claim with ACC?
3. Do you authorise your records to be collected or disclosed to ACC to help determine cover for your claim, determine what you’ll be entitled to, or for research purposes (such as injury prevention, or assessment, and rehabilitation)?
Misuse of Telehealth – disciplinary warning
Chiropractors must not misuse telehealth at any time including during the COVID-19 alert level 4 lockdown.
In current circumstances, patients should only be contacted for telehealth assessments or consultation where such action is clinically justified, or services would have otherwise been provided if chiropractic clinics were fully operational. Similar considerations apply to the frequency of contact with patients.
As autonomous practitioners, you are responsible for your clinical decision making, including the need to identify clinical justification and frequency of services. The Board will take appropriate disciplinary action against a chiropractor who appears to be unethically or unprofessionally taking advantage of telehealth during the COVID-19 emergency or in the future.
For more information regarding completing an ACC claim, please contact the ACC team
This guide needs to read in conjunction with:
- The Board’s telehealth standards
- The Code of Health and Disability Services Consumers’ Rights;
- Royal Australasian College of Physicians’ Telehealth Guidelines and practical tips;
- NZ Telehealth Resource Centre
- The Allied health best practice guide for telehealth
- Risk management for Skype use for clinical video consultations