A Brief History of Australian Telehealth

Telehealth in Australia did not begin with a smartphone. It began in 1928, when the Royal Flying Doctor Service used pedal-powered radio to bring medical advice to patients hundreds of kilometres from the nearest doctor. That tradition — care at a distance, without compromise — has continued through morse code, telephone, and now digital consults. Australia has a longer history of remote healthcare than almost any country on earth.

1928: The pedal radio and the birth of remote medical care

The year Abby Health points to as the origin of Australian telehealth is not a recent one. In 1928, the Royal Flying Doctor Service (RFDS) launched Australia's first flying medical service in Cloncurry, Queensland. Almost immediately, the RFDS began using pedal-powered wireless radio to provide medical consultations to patients in remote stations and settlements — people for whom the nearest doctor might be a day's ride away.

The pedal radio, developed by Adelaide engineer Alfred Traeger, allowed outback families to receive medical guidance, instructions for administering care, and triage advice in real time. The doctor was not present. The patient was not transported. The consultation happened across distance. That is telehealth — almost a century before the term became policy.

From pedal radio came the transceiver. From the transceiver came the morse code medical network. Outback stations tapped out symptoms in dots and dashes and received responses with dosing instructions, reassurance, or a directive to call in the flying doctor for an in-person visit. The system was imperfect, but it was continuous. People in the most remote corners of Australia had access to a clinician who, over time, came to know their history.

Broken Hill: where Australia's care-at-a-distance tradition runs deepest

Broken Hill sits at the western edge of New South Wales, in one of Australia's most historically isolated communities. It was here that the RFDS established some of its earliest and most enduring remote medical operations — and it is here that Abby Health's Chief Medical Officer, Dr Ramu Nachiappan, spent 35 years as a GP.

Dr Ramu's career in Broken Hill is not a biographical footnote. It is the proof of concept for everything Abby is built to do. He knows what it means to be the clinician standing between a patient and the nearest specialist, hundreds of kilometres away. He knows the weight of continuity — what it means for a patient in a remote community to have a doctor who actually knows their name and their history. Abby was not built from a pitch deck. It was built from that understanding.

This is why Abby's founding story begins in the outback, not in a tech accelerator. We have no new vision for healthcare. We have the oldest one. A doctor who knows you. We just have a new way to deliver it.

2011: Medicare enters the picture — but only for specialists

For most of the twentieth century, telehealth in Australia operated outside the Medicare Benefits Schedule. Consultations conducted by phone or, later, by early video platforms were not rebated. Patients and clinicians bore the cost directly, or the care happened without reimbursement — particularly in the community and remote health sectors where the RFDS model had been adapted across decades.

In 2011, the Australian Government introduced the first Medicare telehealth items under the Health Insurance Act 1973. These initial items were narrow in scope: they applied primarily to specialist consultations where the patient was in a rural or remote area and could not reasonably travel to attend in person. The GP had to be present with the patient at the distant site for the specialist telehealth consultation to attract a rebate.

It was a start — but it was a system designed around scarcity and distance measurement, not around the practical realities of how many Australians actually lacked access to care (Department of Health and Aged Care). The underlying idea — that the doctor and patient being in different physical locations was an exception requiring special justification — would not survive the events of 2020.

2020: The pandemic rewrites the rules

In March 2020, as the COVID-19 pandemic reached Australia, the Federal Government made a decision that would reshape primary care permanently. Within days of the national emergency declaration, temporary Medicare telehealth items were introduced covering GP consultations, specialist consultations, mental health services, and allied health — by phone or video, for any patient, regardless of location.

The change was driven by necessity: in-person consultations posed transmission risk, and the existing Medicare framework had no adequate mechanism for general practice to deliver care remotely at scale. The temporary items filled that gap.

What followed was one of the largest and fastest shifts in how Australians accessed healthcare in the system's history. Within weeks, millions of GP consultations were conducted by phone and video. Patients who had previously faced access barriers — due to distance, disability, work hours, or social circumstances — discovered that they could receive quality primary care without leaving home. Clinicians adapted rapidly. The quality of care did not collapse. In many respects, it expanded.

The pandemic telehealth expansion did not create something new. It made visible what the RFDS had known since 1928: most of what a clinician does for a patient does not require them to be in the same room.

2022: Telehealth becomes permanent — and the 12-month rule arrives

In 2022, the Australian Government made telehealth Medicare items permanent. This was not simply an extension of the temporary COVID arrangements — it was a recognition that telehealth had become a normal and expected part of primary care, and that removing access to rebated telehealth consultations would cause genuine harm to patients who had come to rely on them.

Alongside permanence came a new condition that attracted significant debate: the 12-month face-to-face rule. Under this provision, patients seeing a GP by telehealth for the first time — with no established relationship — were required to attend at least one in-person consultation within the preceding twelve months for that GP to bulk bill the telehealth item. The policy intent was to discourage episodic, transactional telehealth relationships and preserve continuity.

In practice, the rule created friction for exactly the patients least able to attend in person: those in rural and remote areas, those without transport, and those seeking care from clinics without a physical presence in their community. Exceptions were introduced for patients in Modified Monash Model (MMM) categories 6 and 7 — the most remote classifications — who are exempt from the face-to-face requirement. For an explainer of how the 12-month rule works and what the exemptions mean, see the 12-month face-to-face rule explained.

Abby's care model is built around continuity. The 71% rebook rate (Abby Health internal data, Q1 2026) — 3 in 4 patients returning to the same clinician — is not just a metric. It is the mechanism by which a patient builds an established relationship with their clinician, and through which the care they receive becomes genuinely continuous rather than episodic.

2024: Nurse Practitioners enter the Medicare mainstream

The most recent significant development in Australian telehealth policy was the November 2024 expansion of Medicare rebates for Nurse Practitioner services. New MBS item numbers, higher rebate values, and a broader range of services eligible for bulk billing brought Nurse Practitioner telehealth consultations further into alignment with GP equivalents.

This mattered particularly for rural and remote patients, where Nurse Practitioners have long been the primary point of clinical contact. In communities without a resident GP, an AHPRA-endorsed Nurse Practitioner providing a rebated telehealth consultation is not a workaround — it is the care system working as it should.

Abby's care network includes Nurse Practitioners working alongside Specialist GPs within the same clinical framework. The 2024 changes mean more of those consultations are now bulk billed for eligible patients. For the detailed policy explainer, see Nurse Practitioner billing and the 2024 Medicare changes.

Where Abby sits in this story

Abby Health is not a telehealth app. It is an online-first clinic — a care network of clinicians, connected by technology, committed to the model of long-term continuous care that a generation of Australians grew up with and that the system has, for too many of them, allowed to erode.

Abby AI, our medical AI, makes continuity possible at scale. Before every appointment, it surfaces the patient's history, medications, risk signals, and follow-ups — so the clinician begins already informed. It does not diagnose. It does not prescribe. It does not replace clinical judgment. It does what the RFDS dispatcher did across the morse code network: it makes sure the right information reaches the right person at the right time.

The 300+ clinicians in the Abby network (Abby Health internal data, Q1 2026) are available seven days a week, 365 days a year. All Abby Health practitioners hold current AHPRA registration. Appointments can be booked at abbyhealth.app/book. For more on who those clinicians are, see who are Abby's practitioners. For more on how Abby AI supports every consultation, see what Abby AI is — decision support explained.

Australia has been solving the problem of care at a distance for nearly a hundred years. The tools have changed. The mission has not.

Frequently asked questions

When did telehealth officially start in Australia?

The Royal Flying Doctor Service began delivering remote medical consultations via pedal radio in 1928, making Australia one of the earliest countries to develop systematic care at a distance. Medicare telehealth items were first introduced in 2011 for specialist consultations in rural areas, expanded significantly during the COVID-19 pandemic in 2020, and made permanent in 2022.

When did telehealth become available to all Australians regardless of location?

The temporary COVID-19 telehealth items introduced in March 2020 were the first time Medicare-rebated telehealth was available to all Australians regardless of geography. Those items were made permanent in 2022, establishing telehealth as a standard part of Medicare-funded primary care.

What is the 12-month face-to-face rule?

Introduced alongside the permanent telehealth items in 2022, the rule requires patients to have attended at least one in-person consultation with their GP in the preceding 12 months for a bulk-billed telehealth item to apply. Exemptions exist for patients in highly remote classifications. See the 12-month face-to-face rule explained for full detail.

How does Abby fit into the history of Australian telehealth?

Abby Health is one of Australia's largest online-first clinics, founded to restore the tradition of long-term continuous care — the family doctor model — for Australians who no longer have access to it. Abby's Chief Medical Officer practised in Broken Hill for 35 years, in one of Australia's most historically isolated communities. The heritage is not incidental to the mission.

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