Defining Location Of Telehealth Services For Regulatory Purposes

As the online consultation concept grows within the healthcare industry, regulators are battling to keep up with appropriate guidelines.

As is often the case with new treatment techniques or approaches, the practice out paces the regulation.

Some agencies that police the quality and complaints of health services feel the need to limit the geographical reach of online interactions.

This is so that the regulatory authorities are clear on whose jurisdiction or territory a complaint may fall into.

Unfortunately, this flies in the face of the main benefit of telehealth:

  • Location independence for both therapist and patient

I do agree that regulations are required, however not at the cost of limiting the main benefits of the format.

The main debate seems to be around this:

Is the ‘location’ of a teleconsultation for regulatory purposes defined by

a) the location of the patient

b) the location of the therapist

c) location of both therapist and patient


In the US, certain states dictate that both therapist and patient must reside in the state to participate in an online consultation.*

In the UK, patients of telehealth must reside in the UK.*

In Australia, the therapist is regulated in Australia. Patient location is not specified, but indemnity insurance must provide coverage.*

*I am not an authority on these regulations – please do your own research.

So let’s have a look at the pros and cons of this debate:


Location of telehealth defined by patient


  • The patient remains in the health system they know and are familiar with
  • Regulators can follow up complaints in the location of the patient, who is the source of the complaint


  • If the patient moves states or countries, they can no longer continue their care
  • The patient cannot access the therapist that may be best suited or qualified to help them because they are in a different state or country


Location of telehealth defined by country of origin of therapist


  • Patient has the right to choose what service they access
  • Therapist can reach a greater population of patients within their specialty area
  • Therapist is clear on the regulatory requirements of their home state/country
  • Both therapist and patient are free to move geographically while maintaining continuity of care


  • Regulators have to work out how to manage patient complaints across borders/countries

Now clearly we have to abide by any regulations that may currently be in place in our state, territory or country.

There is a massive opportunity, however, to be a part of these conversations as the guidelines are being developed.

I personally feel that the country of origin should be dictated by the therapist.

I would love to know your thoughts.

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