Telehealth guides

Telephone and video consultations in general practice: Flowcharts

Flowchart 2. Conducting high‑quality telephone or video consultations

Telephone and video consultations in general practice: Flowcharts

Last revised: 17 Apr 2024

Flowchart 2. Conducting high‑quality telephone or video consultations

Before the consultation – Reception staff

Patient rings practice to make appointment and either requests telephone or video consultation or is advised by reception staff/GP what the best option is

Reception staff confirm that the requested appointment seems appropriate for telephone or video call (with consideration to the patient’s privacy and confidentiality and technological ability/access).

TIPS

There might be times when a telephone/video consultation is not appropriate. Have a plan, and help reception staff know when this might not be appropriate and what to communicate to the patient if this is the case.
ffering patients a long appointment might alleviate any anxiety about feeling rushed during the online appointment.
You might be able to set up your online booking system to include telephone or video consultations. If so, ensure there is a system in place for checking the appropriateness of this, and that information is provided to patients about how the consultation will occur (eg the GP will contact patient on or around appointment time) and the billing arrangements for the consultation.

Appointment time and date is made

Payment method/system is explained and agreed to by the patient (eg that appointment will be privately billed, or appointment will be bulk billed and the patient is happy for rebate to be assigned to the practice). Reception staff member includes booking in GP’s appointment calendar, clearly marking ‘telephone or video consultation’ and the preferred communication method – telephone or video, and software that will be used (eg mobile phone, Skype, WhatsApp). Text message or email reminder sent to patient if this technology is used ordinarily

Before the consultation – GP

Determine (as far as possible) that a telephone/video consultation is appropriate for the patient at the time

TIP

A telephone consultation may have been booked, but it might be that a video consultation is more appropriate for the particular patient.


Ensure your consulting room is set up to afford visual and audio privacy and that external sources of noise are minimised	Test your technology	Before starting the consultation, bring up the patient’s health record, including their phone number, in case the video connection fails

Starting and conducting the consultation


Contact the patient for appointment (call or invite patient)	Confirm audio and visual (if applicable) quality is satisfactory

GP confirms own identity and verifies patient identity (if a telephone consultation) and any necessary introductions are made if the patient has a support person present

TIPS

There might be times when a telephone/video consultation is not appropriate. Have a plan, and help reception staff know when this might not be appropriate and what to communicate to the patient if this is the case.
offering patients a long appointment might alleviate any anxiety about feeling rushed during the online appointment.
You might be able to set up your online booking system to include telephone or video consultations. If so, ensure there is a system in place for checking the appropriateness of this, and that information is provided to patients about how the consultation will occur (eg the GP will contact patient on or around appointment time) and the billing arrangements for the consultation.

Ask the patient to confirm verbally that they provide informed consent for the consultation to take place via telephone or video call, and that they are happy to assign the patient rebate to the GP (if using bulk-billed items)

Check the patient is okay to proceed, and provide any reassurance about privacy/confidentiality from your end if they are anxious about this. Check if they are in a private space and not broadcasting their consultation to others nearby (eg using a hands-free telephone in a car with others)

TIPS

During a video consultation, you may look away from the camera to check/input into the patient’s record or read from another screen. To reassure the patient, tell them what you are doing and that you will be listening at all times.
The call or video may disconnect during the consultation. Make sure you have the patient’s phone number in front of you, and tell them you will call them back if this occurs (eg you will call the patient’s nominated phone number, rather than them calling the practice).
During a telephone consultation, there may be times where there are pauses/ silences when you are looking up information in, or typing notes into, the patient’s record. Reassure the patient by explaining this before and during the consultation.

Begin consultation with the patient

Closing the consultation

Carefully summarise the key points of the consultation, including any agreed follow-up required from the GP or patient (eg booking another appointment; providing prescription, request or referral)

TIP

Electronic prescribing enables providers to send prescriptions directly to patients via SMS or email. Before you end the consultation, ensure the patient is aware of this process and the actions they need to take. If the patient would prefer a paper prescription, they can arrange to pick it up, or have someone pick it up on their behalf, from the practice

Ask the patient if they have any questions, would like to provide any further information or need anything clarified

TIP

The patient may have forgotten to tell you something important or misheard something you said. Check with the patient for any missing information or possible misunderstanding.


Ask the patient if they would like to use telephone/video for future appointments	Advise the patient that you will be ending the phone call/video connection

Following up

Undertake any follow up (eg sending referrals, requests, prescriptions) you were not able to action during the consultation


Ensure the patient’s health record is up to date with consultation notes and actions from the telephone/video appointment, including that it was conducted via telephone/video consultation	Record any technical malfunctions and report to designated person if applicable

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