Telehealth for healthcare providers

Any delivery of healthcare using information or communication technology for someone in another place can be considered telehealth. 

Technology which can be used for telehealth includes:

• Telephone
• Video
• Mobile phone
• Text, SMS, chat and digital messaging
• Apps
• Tablet or computer
• Text, SMS, chat and digital messaging
• Websites
• Email
• Sensors and monitors
• Wearables and implants
• Chatbots and AI (artificial intelligence)

Telehealth is a broad term that can also include activities about specific patients but not directly involving them, such as a digital multi-disciplinary team meeting. Healthcare may be provided to an individual patient or to groups such as whānau or community groups.

• Hybrid consultations, for example a nurse in a rural area may be in the room with the patient, while a specialist joins by video conferencing.
• Remote patient monitoring or telemonitoring is remotely collecting and sending patient data so that it can be interpreted and used in the patient's ongoing management. Telemonitoring allows patients to be at home or in their usual place of residence, such as an aged care facility, while their healthcare team can monitor vitals such as blood pressure, heart rate or activity levels. It can also be used for alarm systems, such as fall detection, and treatment adherence.
• Telemetry refers to collecting and sending data, such as heart rhythm monitoring, in real time.
• mHealth (also known as mobile health) describes the use of mobile communications technologies in medical and public health practice, including the delivery of health information, health services and healthy lifestyle support programmes. Devices from smartphones to tablets and mobile sensors can be used to deliver mHealth. Mobile communications technology enables additional functionality, such as text messaging (SMS), mobile apps, mobile web browsing, video calling, MMS/pxt, QR code scanning and GPS location. The portability and popularity of mobile devices is a major advantage and newer technologies will keep appearing.

Certain types of consultation can be well suited to telehealth, including:

• acute primary care consultations when usual provider unable to meet demand
• follow-up appointments
• appointments which don’t require examination or difficult conversations
• discharge planning meetings
• multidisciplinary team meetings
• some acute secondary care assessments
• ward rounds
• triage assessments
• therapy/treatment appointments.

Considerations for real-time telehealth consultations include:

• privacy
• noise levels and lighting
• workflow and staffing
• equipment
• scheduling time, location and equipment
• the need for an interpreter
• identification of the patient
• consent
• acknowledgement of limitations
• arrangements for viewing images or patient-provided readings
• arrangements for requesting investigations
• arrangements for conversion to face-to-face consultation if clinically indicated
• arrangements for transfer of clinical notes and follow up.

 A telehealth tips sheet for members by members(external link) was created by the RNZCGP in 2022.

• For patients: Faster access to care and shorter wait times. Remote patients can remain close to home, making consultations more convenient and reducing travel.
• Health New Zealand | Te Whatu Ora: Fairer health system because of better access to care. More educational options for DHB staff via specialist video training.
• Specialists/consultants: Less time spent travelling for consultations. Greater control over scheduling. Closer working relationship between specialists and primary care.
• Aged care workers/nurses: Reduced need to transfer to older patients. Increased nurses' knowledge through more exposure to specialist consultations.
• General practitioners: GPs who serve rural health facilities need to travel less frequently. Store and forward allows for accessible referrals and second opinions.
• Allied health workers: Rehabilitation and physiotherapy can take place via video conference, meaning less time and budget spent on travel.

• AI and telehealth (external link)(NZ Telehealth Forum and Resource Centre, NZ, 2023) (59:38 mins)
  A panel of expert speakers explore the intersections of AI and telehealth and its potential to enhance patient care, improve diagnostics and expand access to medical services. They also delve into the challenges AI brings, such as evaluation and regulation, privacy, accountability and much more.
  Panel: Chris Paton, Mike Mulvaney, Tania Moerenhout, Liam Caffery and Robyn Whittaker
  
  
• When the microphone is on(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2023) (1:02:43 mins)
  This session covers everything from why, what and when to record (or not), to who could/should record. An expert panel of presenters draw on international experiences providing valuable insights and recommendations.
  Panel: Dr Samantha Murton, Dr Rob Hendry, Dr Sarah Clarke, Adam Holloway
  
  
• Telehealth success stories from Aotearoa(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (59:34 mins)
  This webinar features 2 successful programmes. DIGIFALE is a digital health equity programme that helps Pacific communities navigate digital platforms to improve their health and wellbeing. Based in Central Hawke’s Bay, Dr Gaddipati has teamed up with Evolko Inc USA, who developed a patient monitoring app that uses artificial intelligence to lead patients through a series of questions for initial triage.
  Panel: Amio Matenga Ikihele, Dr Mohan Gaddipati and Dr Sreekanth Konda
  
  
• Telehealth apps webinar – innovative inclusion for Aotearoa(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (55:02 mins)
  An insightful webinar where moderators Sarndrah Horsfall and Karen Ellis introduce panellists (several of the healthcare providers who have received support from the Digital Enablement Programme) who present and actively discuss their telehealth apps including: Tuku Iho, Digi Language Support (DLS), and Rapid Rehita.
  Panel: Fay Selby-Law, Kelly Feng, Dr Bo Ning, Tom Mclean, Theresa Mclean
  
  
• Lessons learnt and highlights – community telehealth initiatives(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (1:01:49 mins)
  A great line-up of panellists talk about their own experiences in telehealth, and share their learnings, including what’s working and what’s not, along with their highlights and lessons learnt along the way.
  Panel: Jen Coatsworth, Ani Olson, Sue Westbrook, Amio Matenga and Malcolm Kendall
  
  
• Zoom fatigue 'take two'(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (58:04 mins)
  An insightful webinar where panellists share experiences and identify and explore practical ways to overcome fatigue, the impacts of burnout, as well the psychological aspects of being on screen.
  Panel: Alex Kemp, Dr Rachel Webb, Miriam Wood
  
  
• Disability and telehealth 'take two'(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (57:12 mins)
  Panellists address access needs, and engagement for disabled people in telehealth. Hear different perspectives where panellists share experiences, explore the benefits of telehealth for providers and disabled people, and identify difficulties when accessing telehealth services.
  Panel: Mary Schnackenberg, Sue Emirali, Annette Rotherham, Dr Sally Britnell
  
  
• Introduction to telehealth in cancer care(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (59:06 mins)
  This webinar focuses on how telehealth is currently being used in public, private and community cancer care settings and a new breast cancer telemonitoring pilot. There will also be discussion on what changes are needed to better support cancer clinicians using telehealth.
  Panel: Adele Gautier, Elinor Millar, Iain Ward, Jo Stafford, Marie Wales
  
  
• What does telehealth look like in 2022 for primary care(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2022) (57:00 mins)
  The first telehealth webinar of 2022 kicks off with a special webinar brought to you in collaboration with Aotearoa Collaborative. Panellists will talk to their own experiences in primary care, including telehealth in oncology and palliative care, patient portals and the importance of video consultations in a Omicron COVID-19 world.
  Panel: Jess White, Dr Janine Bycroft, Dr Jeff Lowe, Angela Blunt, Tania Kemp
  
  
• Telemonitoring(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2021) (1:07:39 mins)
  This month’s webinar explores telemonitoring and marks the launch of the National Remote Patient Monitoring guidelines developed from experience and guidance from members of the Virtual Health Industry Group (VHIG) within the NZ Health IT (NZHIT) cluster, in collaboration with the New Zealand Telehealth Leadership Group (NZTLG).
  Panel: Christopher Dawson, Kathryn O’Neill, Mark Smith, Philip Jones, Jeremy Morris
  
  
• Improving Māori health gains(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2021) (1:03:51 mins)
  Digital enablement tools are used daily in Aotearoa to support and improve Maori hauora. This webinar delves into virtual services who navigate to engage and serve Maori, Pacific and other communities with unmet needs.
  Panel: Sasha Webb, Jade Chase, Dr Mataroria Lyndon, Dr Lily Fraser, Bernard Te Paa
  
  
• Telehealth mental health(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2021) (1:13:01 mins)
  The panelists presents some of their projects and reveal insights on a telehealth approach for assessing and addressing those with mental health issues, and how this can build capacity to support the youth and the elderly, and beyond.
  Panel: Dr Siale Foliaki, Dr David Codyre, Dr Lyndy Matthews, Dr Janine Bycroft
  
  
• Telehealth international leaders(external link) (NZ Telehealth Forum and Resource Centre, NZ, 2021) (56:25 mins)
  This webinar extends beyond the New Zealand border to learn about telehealth on an international scale. With panellists from Scotland and Australia, this is an interesting discussion exploring three key themes and how they have fundamentally changed the future of the healthcare industry.
  Panel: (Scotland) Margaret Whoriskey, Nessa Barrt, Morag Hearty (Australia) Nicole Bate, Kate Hawkings
  
  
• Allied Health(external link) (NZ Telehealth Forum and Resource centre, NZ, 2020) (59:58 mins)
  Moderated by Rebecca George, this webinar focusses on telehealth adoption in allied health. This specialised topic features panellists who will share their experiences and thoughts on the benefits and challenges for continued high-quality care.
  Panel: Pip Zammit, Sharon Russell, Miranda Buhler, Aoife O’Reilly, Aimee Dackers

Video: Bill's telehealth story

(Nelson Marlborough Health, NZ, 2021)

Video: Nelson Marlborough telehealth 

Nelson Marlborough Health is aiming to increase the use of Virtual health clinic clinical consultations to avoid the stress and travel for patients associated with attending appointments in person. In this video, clinicians talk about their experiences using telehealth.

(Nelson Marlborough Health, NZ, 2020)

Statement on use of the internet and electronic communication(external link) Medical Council of New Zealand
Telehealth March 2020(external link) Medical Council of New Zealand
Telecommunications information privacy code 2003(external link) Privacy Commissioner, NZ
Revised Specialist GP telehealth consultations position statement(external link) RNZCGP, NZ, 2024
Guidelines for the use of telepsychology in the treatment of ACC clients(external link) ACC, NZ
Clinical images and the use of personal mobile devices – a guide for medical students and doctors(external link) NZMA, 2020 

Telehealth topics