Is telehealth as safe as face-to-face care? What the evidence says.

Telehealth is now part of everyday care

Telehealth moved from the margins to the mainstream in Australia in 2020, and it has stayed. In 2022 there were more than 45 million telehealth consultations nationally, and telehealth made up 22% of GP consultations, 14% of specialist consultations and 27% of mental health consultations.¹

For practice owners and new healthcare founders, the question we hear most is simple: is it safe?

What the best evidence says

The strongest answer comes from a 2025 systematic review and meta-analysis by researchers at Bond University’s Institute for Evidence-Based Healthcare and the University of Oxford, published in the Journal of Telemedicine and Telecare.¹ It pooled randomised controlled trials, the most reliable type of study, comparing telehealth (by phone or video) with face-to-face care. It found:

• Emergency department visits: no difference (risk ratio 1.07, 95% confidence interval 0.89 to 1.29).
• Hospital admissions within 12 months: no difference (risk ratio 0.89, 95% confidence interval 0.56 to 1.41).
• Deaths and other adverse events: no difference.
• Costs of care and patient satisfaction: similar.

Ten trials compared telehealth with face-to-face care, across primary care, hospital outpatients, patients recently discharged from hospital and residents of aged care. Six further trials compared phone with video and again found no differences in emergency visits, hospital admissions, deaths, adverse events, costs or patient satisfaction. Clinicians’ satisfaction with telehealth was high.

The authors concluded that telehealth, by phone or video, may be an appropriate alternative to face-to-face care, because it does not increase the likelihood that patients end up in the emergency department.

What the evidence doesn’t say

These results are reassuring, but they have limits worth understanding:

• Ten trials is a solid base, not the final word. Most were judged at low risk of bias, but four had some concerns or a high risk.
• Trials study particular patients and conditions. They don’t show that every consultation can safely happen remotely.
• Some care needs hands and eyes in the room, such as physical examinations, procedures and assessing some very unwell patients.

What makes a telehealth service safe in practice

In our experience, safety comes down to the operation behind the call. The services that work well have:

• Clear rules for which consultations suit telehealth, and when a patient must be seen in person.
• Triage and escalation pathways, including red flags that send patients to emergency care straight away.
• Identity checks, informed consent and privacy built into the booking flow.
• Reliable follow-up for results, referrals and prescriptions, so nothing falls through the gaps.
• Continuity of care, with notes shared with the patient’s usual GP where the patient agrees.
• Training for clinicians and staff, and a simple way to report and learn from incidents.

Questions to ask before you launch or expand telehealth

1. Which consultations will we offer by telehealth, and which will we always see in person?
2. How will we triage patients and escalate anyone who needs urgent care?
3. How do we confirm identity and record consent?
4. How will results, referrals and follow-ups be tracked?
5. Which Medicare, prescribing and privacy requirements apply to our model?
6. How will we measure safety, patient experience and revenue?

If you’d like a second pair of eyes on any of these, see how we help with telehealth operations.

1. Scott AM, Sanders S, Atkins T, et al. The impact of telehealth care on escalation to emergency care: a systematic review and meta-analysis. Journal of Telemedicine and Telecare, 2025;31(8):1059–77. Australian telehealth figures are Department of Health and Aged Care data cited in the review.