The Board of Healthcare Funders has welcomed the lifting of the Health Professions Council of South Africa (HPCSA) telemedicine ban to broadly permit doctors and therapists to use video or phone calls to treat any patients using telemedicine.

 “Telemedicine is critical for enabling access to healthcare, and within the context of the coronavirus disease (COVID-19) it will minimise the risk of contamination,” says Dr Rajesh Patel, Head of Benefit and Risk, at the Board of Healthcare Funders (BHF).

He noted that while this is a great move by the HPCSA, this exemption should be extended beyond COVID-19 to broadly enable efficiencies within healthcare system in the future, as South Africa is still lagging in terms of its uptake of telemedicine.

The HPCSA had previously banned all forms of telemedicine. The Council recently relaxed the restrictions to allow telemedicine for the period of the coronavirus outbreak, for doctors to help only existing patients via video call and psychologists to use video or telephone calls to counsel new patients.

The HPCSA has since amended its telemedicine guidelines Clauses (b) and (c) respectively.

Clause (b) of the Application of Telemedicine Guidelines During the COVID-19 Pandemic stated: “Telehealth is only permissible in circumstances where there is an already established practitioner-patient relationship, except where Telepsychology and/or Telepsychiatry is involved, in which case telehealth is permissible even without an established practitioner-patient relationship”.

The clause has been amended to state that: Telehealth should preferably be practised in circumstances where there is an already established practitioner-patient relationship. Where such a relationship does not exist, practitioners may still consult using Telehealth, provided that such consultations are done in the best clinical interest of patients.

Clause (c) stated: “Practitioners may charge a fee for services rendered through a telehealth platform”.

This has been amended to state that: Although practitioners may charge fees for consultations undertaken through Telehealth platforms, the Council strongly cautions against practices that may amount to over-servicing, perverse incentives and supersession.

Practitioners must still uphold the Ethical Rules of Conduct for Health Practitioners registered under the Health Professions Act, as these remain applicable during the practice of Telehealth.

The HPCSA has noted that these new guidelines are only applicable during the COVID-19 pandemic and the HPCSA shall inform practitioners of when this guidance will cease to apply.

“It remains critical for the HPCSA to look at a long-term view of the application of these telemedicine guidelines to support efforts aimed at health systems reform, and to minimise unnecessary face to face consultations. This will reduce the burden on healthcare facilities and in turn help overcome barriers to access to health services,” said Dr Patel.