FAQs for Chinese medicine practitioners who provide virtual care

For the purposes of these FAQs, ‘virtual care’ is defined as a broad term for health care services provided by practitioners to patients through digital communication channels such as video calls, phone consultations, online messaging or similar, that allows them to interact with patients without a physical presence. It can include telehealth (telephone and video-enabled), telemedicine, tele-education, teletherapy, online prescribing and telemonitoring.

Virtual care does not refer to the use of technology, such as voice-to-text notes or automated predictive apps, and similar, during a face-to-face consultation.

All registered Chinese medicine practitioners can provide virtual care if it is safe, clinically appropriate for the service being provided and suitable for the patient or client.

The Board's position is that it would not be safe for a practitioner to conduct a virtual care appointment without first conducting a face-to-face appointment.

Once ongoing virtual care has begun, practitioners should schedule face-to-face appointments to take place every six months (or sooner if the presenting complaint changes). The practitioner should provide face-to-face appointments at least once every 12 months.

The Board has the same expectations of Chinese medicine practitioners using virtual care to provide patient consultations/patient services as it does when practitioners are delivering services face-to-face. These are set out in the Professional Capabilities for Chinese Medicine.

Further advice on how practitioners are expected to practice when providing virtual care can be found in Information for practitioners who provide virtual care.

The shared Code of conduct states that practitioners should practise safely, effectively and in partnership with patients. Chinese medicine practitioners must consider whether the care that they provide virtually satisfies these requirements. The Professional capabilities for Chinese medicine practitioners state that practitioners should ‘exercise appropriate levels of autonomy and professional judgement’.

Information for practitioners who provide virtual care states that practitioners can use virtual care if:

• they are appropriately skilled and competent,
• it is safe and clinically appropriate for the health service being provided, and
• it is suitable for the patient¹.

¹Patient means a person who has entered into a therapeutic and/or professional relationship with a registered health practitioner. The term ‘patient’ includes ‘clients’ and ‘consumers’. It can also extend to their families and carers (including kinship carers), and to groups and/or communities as users of health services, depending on context.

There are types of Chinese medicine treatments that are not appropriate for virtual care. The position of the Board is that it is considered inappropriate to provide acupuncture via virtual care. The shared Code of conduct states that practitioners should practise safely, effectively and in partnership with patients. Chinese medicine practitioners must consider whether the care that they provide virtually satisfies these requirements. Any treatment that may potentially cause harm to a patient is not appropriate for virtual care. Practitioners who provide treatments via virtual care may be asked to demonstrate how the care provided is safe and appropriate, and adheres to the Board’s guidelines, such as the Guidelines on infection prevention and control in acupuncture and related practices, the Guidelines on safe Chinese herbal medicine and the shared Code of conduct.

The Board expects any practitioner prescribing herbal medicine during a virtual care appointment to adhere to the Guidelines on safe Chinese herbal medicine practice at all times, as they would during a face-to-face appointment.

Practitioners who prescribe herbal medicine should be aware of and comply with relevant state, territory, and jurisdictional legislative requirements for prescribing medicines.

Information for practitioners who provide virtual care states that it is not good practice for practitioners to prescribe (herbal) medicine for a patient that they have not consulted before, whether face-to-face or via virtual care. For Chinese medicine practitioners, this includes requests for herbal medicine communicated by text, email or online that do not take place in real-time and are based on the patient completing a health questionnaire where the practitioner has not formally consulted with the patient.

Any practitioner who prescribes for patients in these circumstances may be asked to explain how the prescribing and management of the patient was appropriate and necessary in the circumstances.

If a patient is located outside of Australia, registered Chinese medicine practitioners are expected to continue to comply with the regulatory frameworks of the Board, including standards, codes and guidelines. The practitioner should also ensure that they hold appropriate professional indemnity insurance and should check whether they are required to be registered by the relevant regulatory authority for Chinese medicine in the country where the patient is located and comply with legislative requirements in that jurisdiction, including for prescribing and professional indemnity insurance.

Further details on providing virtual care when a patient is based outside of Australia can be found in Information for practitioners who provide virtual care.

Practitioners based outside of Australia are expected to be registered by the Board before providing a health service to patients located in Australia, including virtual care services. Limited exceptions may apply in circumstances where the patient is located in Australia, managed by an Australian-registered practitioner, and another practitioner is providing a second opinion or advice to that practitioner.

For more information about registration, including information about when the Board expects a practitioner to be registered, refer to the Board’s website.

A principle of the shared Code of conduct is that practitioners ‘should communicate with all patients in a respectful way and meet their privacy and confidentiality obligations including when communicating online.’ As with face-to-face consultations, virtual care consultations must:

• respect the confidentiality and privacy of patients by seeking informed consent before disclosing information, including formally documenting such consent where possible,
• provide surroundings to enable private and confidential consultations and discussions, particularly when working with multiple people at the same time, or in a shared space, and
• be aware of the requirements of the privacy and/or health records legislation that operate in the relevant states or territories, and apply them to information held in all formats, including electronic information.