Nearly 70 percent of physicians are willing to use telemedicine, according to a recent survey, but what the survey didn’t measure is what percentage are concerned about legal issues in telemedicine. Considering the broad variance in telemedicine regulations across the nation, the concern is certainly a valid one. Here are some areas in which newly-minted telemedicine physicians should tread carefully to avoid running afoul of the law.
Different states, different rules
State regulations governing telemedicine usage vary widely; providers using the technology need to familiarize themselves with the local restrictions. For instance, in some states, physicians must see patients in person prior to offering any telemedicine services. Some states permit synchronous (real-time) and asynchronous interactions, while others allow only synchronous visits. And some states allow physicians to prescribe certain controlled substances under specific circumstances.
If a physician has patients out-of-state, then the laws of the state where the patient is located take precedence. Of course, in order to treat a patient in another state, the doctor must also be licensed in that state.
Multiple state licenses
Industry experts advise physicians to examine their patient populations to determine whether they have a significant number of patients who live in a neighboring state, who re-locate for part of the year, or who travel extensively. If a physician wishes to continue seeing those patients while they are out-of-state, then he/she must apply for a medical license in the appropriate states.
Obtaining licensing for just a few states isn’t bad, but more than that can become time-consuming and expensive. To simplify the process, 28 states have joined the Interstate Medical Licensure Compact; member states offer reciprocity, meaning that each state recognizes other member states’ licensing requirements and does not require physicians to review and meet their own requirements to obtain a license.
Privacy and security
All telemedicine encounters must meet all HIPAA requirements for privacy and confidentiality. The technology in use must comply as well, such as secure connections and fully encrypted data transmission. Any third party telemedicine vendors must also comply with HIPAA rules. Consumer videoconferencing software, such as Apple’s FaceTime or Skype, do not meet HIPAA requirements and thus cannot be used for medically-related purposes.
The addition of telemedicine into one’s practice often entails adjustments in workflow, care delivery, and “webside” manner. Specialized training can help physicians ensure they are following rules appropriately, offering the best care possible, and connecting with patients on a more personal level despite the distance. For instance, while eye contact comes naturally in an in-person conversation, simulating this intimacy during a video conference calls for the speaker to look directly into the camera rather than the listener’s on-screen image.
According to industry experts, physicians who offer telemedicine services do not face new malpractice risks or rules. As long as physicians follow licensing rules, document appropriately, and follow the same standards of care they would use for in-person treatments, there are no additional malpractice risks specific to telemedicine.
The above cautions may seem daunting, but with careful planning, the legal issues in telemedicine should not hinder care providers from adding telemedicine services to their practices. In fact, considering that consumers are increasingly looking for convenient health care and technology-enabled care, physicians should at least provide telemedicine within their own states—or risk getting left behind.
To read more about how to navigate around legal issues in telemedicine, visit Medical Economics here.