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April 30, 2014

Can you have telehealth without a telephone? New policy causes 'stir'

Daily Briefing

    The Federation of State Medical Boards (FSMB) has approved a model telehealth policy that emphasizes the use of video technology—and not a telephone—during a patient's first telehealth visit.

    JAMA: Telehealth reduces mortality rates, length of stay for ICU patients 

    Policy details

    The 11-page "Model Policy on the Appropriate Use of Telemedicine Technologies in the Practice of Medicine" was developed by an FSMB workgroup. The policy is a non-binding guide for the FSMB's 70 member boards and is intended to serve as a consistent, nationwide approach to the use of telehealth technologies.

    The model policy calls on providers to:

    • Use video technology rather than audio or email technologies for their first telehealth encounter with a patient; and
    • Create credible "patient-physician" relationships that ensure patients are appropriately evaluated and treated and follow established guidelines for data privacy and security, informed consent and safe prescribing.

    In addition, the policy calls for the same standards of care for in-person health care visits to also apply to telehealth.

    According to Clinical Innovation & Technology, state boards have the option of adopting the new policy, altering the policy before adoption, or choosing to keep their current telehealth policies.

    Where hospitals are most likely to embrace telehealth

    Reaction

    According to Teladoc CMO Henry DePhillips, representatives from Kaiser Permanente and patient advocacy groups during an FSMB committee hearing on Friday opposed the model policy's restriction on audio technology during first-time telehealth visits.

    DePhillips said that in his company's experience, consumers "over 95% of the time, will choose the telephone, even if they have the device and bandwidth" for video conferencing with their physicians.

    Meanwhile, the American Telemedicine Association has suggested changing some of the provisions in FSMB's model policy, including language that:

    • Allows patients to select the physician providing their telehealth services, rather a provider assigning them one;
    • Defines telemedicine without including telephone and email technologies;
    • Requires physicians to be licensed in the same area where a patient is located; and
    • Requires doctors to identify themselves and their credentials before treatment, which ATA argues sets a higher standard than most states require for in-person medical visits (Hall, FierceHealthIT, 4/25; Conn, Modern Healthcare, 4/28; Walsh, Clinical Innovation & Technology, 4/28).
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