Telehealth (Web App)

The original objective of Telemedicine as established by the National Department of Health was to

1. deliver healthcare services at a distance to South African communities in under-served areas;
2. to alleviate the human resource crisis as experienced
3. to improve the links and communication between developed healthcare facilities and the underdeveloped rural areas.

On 26 March 2020, the HPCSA issued their first letter to practitioners after the National State of Disaster was announced by the government following the rise in the number of reported Covid-19 cases in South Africa.

The two main measures implemented by the government to limit the spread of the disease are:

Medical practitioners provide essential services to the community and as such the HPCSA urged practitioners to continue providing medical services with reasonable skill and competency while also keeping the safety of their patients and themselves in mind. In order to ensure the safety of patients, Telehealth was introduced as a means to assist with social distancing without compromising on good healthcare services. Telehealth should only be used if it is found to be in the best interest of the patient.

The HPCSA has changed the name of this concept from Telemedicine to Telehealth. Telehealth is defined as a remote consultation between a practitioner and patient via telephone or virtual platform.

The HPCSA also expanded the application scope to include patients who do not have an existing practitioner-patient relationship.

The HPCSA specifically referred practitioners to ethical Rule 27A.

Main responsibilities of healthcare practitioners:

The HPCSA’s ethical rule 27A describes the main responsibilities of healthcare practitioners. The sub-rules that specifically pertain to Telehealth are as follows:

• Sub-rule (a) states that a practitioner shall at all times act in the best interests of his or her patients; this is the overarching rule when it comes to healthcare. All actions will be measured based on this rule.
• Subrule (b) states that a practitioner shall respect patient confidentiality, privacy, choices and dignity;
• Subrule (f) states that a practitioner shall maintain proper and effective communication with his or her patients and other professionals;
• Subrule (g) states that a practitioner shall, except in an emergency, obtain informed consent from a patient or, in the event that the patient is unable to provide consent for treatment himself or herself, from his or her next of kin; and
• Subrule (h) states that a practitioner shall keep accurate patient records.

When choosing a platform to use for Telehealth consultations, it is vital that the practitioner ensures that all these requirements are met. This course will illustrate how proper practice management and the correct use of software can greatly assist practitioners to comply with these rules.

We can now see that the diversified purpose of Telehealth has become to promote healthcare to:

1. Patients in underdeveloped areas
2. Patients at risk to the practice (e.g. Covid-19)
3. Patients who cannot travel, e.g. frail patients as well as
4. Patients who are in urgent need of assistance without placing an extra burden on ER facilities
5. Patients who live too far from a Practitioner, effectively eliminating the barriers of geographical distances.
6. Patients have become aware of the immense benefits of Telehealth and we suggest that Telehealth in its new form is here to stay and that practitioners will do well to become more acquainted with this form of healthcare.

Benefits of Telehealth:

1. There is less chance of catching new illnesses by keeping social distancing from other patients
2. It increases the efficiency of the practice to assist a broader base of patients
3. Patients with limited mobility have better access to healthcare, e.g. frail patients
4. The whole consultation process is quicker for patients who e.g. don’t have to travel
5. It is cost-effective, seeing that patients have the ability to engage in Telehealth rather than go to an emergency room for no good reason.
6. Allows multiple members of a team to interact and collaborate in patient care, e.g. specialists.