Telehealth or virtual healthcare provides a way of having an appointment with your doctor, nurse, psychologist or other healthcare providers without being in the same place. It’s sometimes called an e-consultation.
On this page, you can find the following information:
This is a new way of seeing your healthcare team. Your first consultation may seem strange for both you and your healthcare provider, that’s normal. As we do this more often everyone will start to feel more comfortable.
What is telehealth?
Telehealth or virtual healthcare provides a way of having an appointment with your doctor, nurse, psychologist or other healthcare providers without seeing them in person. It's sometimes also called e-consultation.
Telehealth involves having a video call where you can see a healthcare provider such as your doctor, specialist or nurse and talk about your condition just as you would if you were in the same room.
Some of the benefits include:
removing the risk of catching or spreading germs
reducing time and costs involved with travelling to an appointment
not having to leave the house when you are feeling unwell.
(ProCare, NZ, 2021)
What can I expect from a telehealth consult?
Different health professionals will have different approaches to what or who they communicate with using these technologies. This depends upon their level of experience and what facilities they have available to them, and to you.
Here are some commonly asked questions about what you can expect:
Do I need to pay?
If the consultation is through a private healthcare facility, such as your family doctor/GP, you will be asked to pay for the health professional’s time. This will differ by health professional but expect to be asked to pay an ordinary consultation fee for a video consult.
Will my information be secure and safe?
Yes, your health professional will keep your information secure and safe, and will treat the information you share with them in the same way as they normally would if you were to see them in person.
What if I need a physical examination?
As your health professional will not be able to examine you, sometimes you may be asked to examine yourself. For example, you may be asked to feel your tummy for where it is sore. Sometimes it can help to have someone else you are comfortable with do this for you. This could be a family member, a friend or another health professional.
What if I need my blood pressure, heart rate and temperature measured?
If you have your own equipment, you may be asked to take your own blood pressure, heart rate and temperature. Taking your own pulse can be quite easy. You can find it in your neck or in your wrist close to the base of your thumb and time it over one minute.
If you are having a scheduled appointment you are likely to be sent a link by email (sometimes by text). You will need to click on this link. Take care that the link is the one you were expecting from your healthcare professional.
Make sure you are in a comfortable and private place.
It's best if have a hands-free device. If you have a smart phone, find a way to prop it up so that you can move about.
Make sure that you have tested out your audio. You may need to have a set of earphones to hear well.
You may want to have a whānau member or friend with you. That’s fine – just tell the health professional when you join that they are there.
Write a list of what you want to talk about and have a pen and paper handy to write anything down if you need to.
Have all of your medicines with you, either in a list or in the packaging.
Make sure that there is no one else streaming information from linked-in devices while you are having your consult, eg, if someone is watching a video on the wi-fi network you are using, your video may be poor quality.
(Health Navigator NZ, 2020)
How do I keep myself safe using telehealth?
Telehealth services are secure and the same levels of privacy and security apply to this type of consultation as they normally would for your normal doctor visits.
Check out the instructions on how to use the telehealth service and enable all security and privacy features before you have your first virtual consultation. Some services may have a waiting room so you can test the connection in advance.
If possible, close any other applications or web-browser windows before and during the consultation to avoid performance and security issues. If internet speed is an issue, turning off video might help.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Janine Bycroft, GP
Last reviewed: 20 Mar 2020
Many of your health consultations will now only be offered by telehealth. Unless you need to be seen in person, your doctor, nurse and other health provider will ‘see’ you using a number of different digital health technologies.
This new way of seeing your doctor and other health providers is part of keeping physical distance from each other as much as possible – something we need to be doing to help keep everyone safe during the COVID-19 pandemic.
Telehealth is the collective term for a number of different ways of being in touch with your doctor, practice nurse and other health providers without seeing them in person.
This might involve talking over the phone, sending messages via your patient portal, emailing or texting your doctor, practice nurse or other health provider, or having a video call where you can see your health provider and talk about your condition just as you would if you were in the same room.
Sometimes this is called virtual healthcare or e-consultation.
Why are health consultations being offered via telehealth?
This new way of seeing your doctor and other health providers for most appointments is part of keeping physical distance from each other so we help keep everyone safe during the COVID-19 pandemic.
These ways are to make sure you are not exposed to the virus if someone with it comes into your doctor’s practice or psychologist’s office. It also helps make sure you don’t spread the virus if you don’t know you’ve got it.
Who can benefit from telehealth appointments?
If you have difficulty getting to your appointments due to cost, mobility issues, living remotely or lack of transport options, telehealth can make it easier for you to get your healthcare needs met.
If you have a communicable disease (one that can be passed on to other people), using telehealth helps to keep other people safe from catching that disease.
It's also a good option if your appointment is a follow-up rather than a first consultation. It's a good way to stay in touch with your doctor on a more regular basis if you have a chronic health condition.
If you are self-isolating, you must use some kind of telehealth option rather than turn up or expect an in-person visit. Ring first and if more is needed, the healthcare team will advise you what to do.
How do I arrange a telehealth appointment?
Visit your medical centre's website or patient portal to find out how they would like you to book appointments. There will also be a message on most clinic answer phones. While clinics are transitioning to more telehealth, they may wish all appointment requests to be triaged first. This means someone will talk with you to help decide what form of appointment will be best for you.
In most practices. you will be asked whether you prefer to have your consultation by secure email through your patient portal, or by phone or video call. What is available depends on the technology your healthcare provider's has available. You can also request a video consultation for your child.
You will be sent an appointment time and instructions about how to login for video calls or what time to expect a phone call. The medical team will try to be on time, but as you can understand, they are juggling lots at the moment and may be running late at times. Please be patient. They will ring or log on to meet with you as soon as they can.
How do I decide which type of telehealth option to use?
If you have a straightforward question, you may find the email option works best. This might include, eg, checking something that your doctor or nurse said to you at a recent consultation, or you need a repeat of your medication when you wouldn't normally need an examination to get a repeat. You can write your email and read your doctor or nurse’s reply at a time that suits you.
If you need to discuss something in more detail, then a phone or video call at an agreed appointment time will be a better option. If your doctor or nurse is likely to need to ask you to show them something, such as a rash, or get you (or someone in your home) to do something such as take your pulse, then a video call would be best.
What conditions are best suited for telehealth consultations?
Each health provider will make their own decisions about who should come in for a face-to-face consultation. However, conditions that are likely to be suited to a video consultation include:
urinary tract infections (UTIs)
colds and flu
constipation and diarrhea
headaches (except sudden, severe headaches)
mood and anxiety issues
follow up of some injuries (needing medical certificate extended or back to work clearance)
follow up for WINZ medical certificates
off work certificates (if not seriously unwell)
ongoing monitoring of many long-term or ongoing conditions (arthritis, diabetes, heart disease etc).
Telehealth consultations are not recommended for:
acute or severe chest pain
actively bleeding or deep wounds or laceration
psychosis or delusions
severe abdominal pain
inability to control bowel movements (pooing) or urination (peeing)
severe headache or giddiness
sudden onset numbness, weakness or slurred speech
suspected broken bones
injuries causing severe pain, open wounds, severe bruising or swelling, loss of sensation, limb weakness etc
sudden loss of vision.
You are also required to be seen for an in-person consultation for:
first ACC certificates (accidents and injuries)
first Work and Income medical certificates.
What should I do before any telehealth appointment?
Write down the questions you want to ask your doctor, nurse or health provider. Also write down a list of all your medications, supplements or vitamins or have them with you for the consult. Have pen and paper handy to write down any advice or other information you may need to.
You also need to make sure you know how to use the technology for the type of consult you have chosen and that the camera (for video) and microphone/speakers (for sound) are working well.
Make sure you login well before your video appointment to test the connection and seek help from whanau if needed.
What else do I need to do before an email consult?
Most health providers will use the email function of your patient portal as it is not secure or safe to use normal email. Make sure you are registered with the patient portal for your general practice. See this guide to patient portals to help you with this.
If you use online banking or other online functions you will find this easy to use. If not, it is easy to learn and worth the effort of getting set up. Ask whanau or the clinic for help. Make sure to keep your password secure and do NOT share with anyone else.
Once you are registered, make sure you know how to log in and find the 'Send a message' section within the portal.
What else do I need to do before a phone consult?
Your health provider will call you at the approximate appointment time at the number you have given. Make sure you are by the phone you gave the number for. Also make sure you are in a quiet and private place so you can talk freely and can hear well. If you are using a mobile phone, make sure it is charged beforehand.
What else do I need to do before a video consult?
Your doctor will send you a video link to the platform they are using for video calls. This may come by email or text. You will need to click on this link. Take care that the link is the one you were expecting from your healthcare professional.
Click on the link from the device that you will be having your video consult on. A computer or laptop is better than a hand-held device because you will then have your hands free if you need to show your doctor something on your body or do something they ask you to do, like take your pulse or write down instructions.
You can test out most video consultation platforms first, so check in plenty of time before your appointment that your link works and you can access the service.
You also need to make sure your audio and video are working. On the device you are using, test the sound (audio) and video (image). If you have any trouble with the audio, you may find that headphones work better. Get someone from your whānau to help you if you need to.
Decide where you will have the consultation. Choose a quiet, private place where you have access to a strong internet connection. If possible, use a device that is wired for fast internet. Otherwise check you have a strong wifi signal.
Make sure your device is charged or your computer plugged in.
A few minutes before your appointment, click on the link your doctor, nurse or other health provider has sent you. Some systems will take you to a virtual waiting room. Your health provider will join you when they are ready. While you are waiting, check that you have turned on your audio and video.
What if my doctor, nurse or other health provider can't hear me in my video consultation?
Check again that your mic is working. Look for a symbol on your screen that looks like a microphone. If it has a line through it, it’s not on. Click on it to turn it on.
What if my doctor, nurse or other health provider can’t see me in my video consultation?
Check again that you have turned on your device's camera. Look for a symbol on your screen that looks like a video camera. If it has a line through it, it’s not on. Click on it to turn it on.
Images: Zoom, US
When can I see my doctor or nurse in person?
If your doctor or nurse needs to examine you, you will still need to come in for a face to face appointment. They will explain if this is needed.
What should I do if I think I have COVID-19?
If you have travelled overseas in the past 14 days, or have been in close contact with someone who has COVID-19, and you think you might have the symptoms of COVID-19, phone your GP Healthline (for free) on 0800 358 5453 (or +64 9 358 5453 for international SIMs).
Is telehealth safe and private?
Telehealth services are secure and the same levels of privacy and security apply to this type of consultation as they would for your normal medical visits. They will not be recording you. In rare cases, they may ask you for permission to record a consultation for teaching or research purposes, but this would be clearly explained, as it would for any in-person consultation.
Yes, if you are seeing your family doctor, practice nurse or any other private health provider, you will still pay a consultation fee. The cost will be similar to usual consultation charges as it still takes staff time and effort to manage.
What about my specialist or DHB appointments?
Given the COVID-19 emergency, hospitals and outpatient clinics will also shift to more telehealth consultations. This can save you a lot of time and effort so you will probably be pleasantly surprised how well it works.
Photos can help your GP or another health professional diagnose skin and other health conditions in a virtual consultation. The photos can be kept in your medical record and may help with managing your health condition over time.
If you need a specialist appointment, the photos can be sent to the specialist. The specialist may also be able to see you in a virtual consultation.
Not every condition can be diagnosed with photos. Your healthcare provider may need to see you face to face so they can examine you.
There are a few simple tips to help you get good photos. You don't need to be a professional photographer.
Set up for the photos
Find a suitable private location.
Get help from someone if you can't reach the location on your body or get a good angle for the photos.
Try to use a plain background such as a white sheet or pillowcase, a plain wall or a plain carpet.
Take the photos
Make sure there's good lighting. If necessary, use a flash.
Think about what photos are needed. For example, you might need:
an overview shot showing the location of the condition
a close-up, usually at a distance of around 20 cm
a whole body shot showing how much of your body the condition affects.
Including a ruler or measuring tape in the close-up photo may be helpful. For example, it can show the size of skin lesions.
Make sure the photos are well-focussed
With an iPhone or Android phone, you can focus the camera lens on a specific area. To do this, point the camera at the object or rash you want to photograph and tap the touch screen where you want the camera to focus.
Reduce camera shake by holding the camera or part of your arm against a solid object like a couch, chair or wall.
When you've taken the photo, check its focus by enlarging the image on the screen. A well-focussed image will stay sharp when it's enlarged. Make sure the area with the condition is clear.
If the photo isn't well-focussed, take another one.
Send the photos
Ask your healthcare provider about the best way to send them your photos. This might be via their patient portal or by email. Unless told otherwise, don't send your photos to the healthcare provider's general email address. These emails may be cleared by non-medical staff.
Send two or three really good photos rather than lots of poorer quality ones.
A good photo size is between 100 KB and 1 MB. This is often the "large" option when sending a photo from a phone. This is a resolution of about 1200 x 900 or 1 megapixel.
Make sure you include the name and date of birth of the person the photos are of. This is especially important if you're sending photos of someone else. For example, your child.
Keep the photos on your phone until you're sure they've arrived at the destination.
A short video can help show seizures, tremor and other movement problems. Ask your healthcare provider about the best way to send them your videos. Video files are usually too large to send by email or patient portal. But you may be able to upload them to cloud storage like Google Drive or Microsoft OneDrive and share the link with your healthcare provider.
There are online modules designed to ensure there is in-depth learning content covering how to prepare for and conduct effective culturally appropriate telehealth consultations. They aim to ensure clinicians develop the necessary skills, knowledge, and confidence in delivering culturally appropriate consultations over telehealth modalities. Learnonline, NZ, 2022.