No matter how much a healthcare facility wants or needs telemedicine, few things can stop telemedicine adoption faster than contrary regulations or laws. This recently proved true in Mississippi, which has just 64.4 primary care physicians per 100,000 residents—far less than the national median of 90.8. To add insult to injury, some rural hospitals have had to close emergency rooms or shut down entirely due to financial difficulties. This setting may look perfect for the implementation of telemedicine as a remedy, but existing state regulations have quickly nixed this potential solution.
For rural and small hospitals, keeping an emergency room open 24 hours a day is expensive; several physicians must be hired to cover those shifts. Emergency telemedicine can ease the pain by allowing the emergency room to be staffed with a physician assistant or advanced practice registered nurse; when a patient arrives, telemedicine is used to consult an emergency medicine physician in another location, such as a larger hospital, for evaluation and diagnosis. The doctor then guides the nurse or physician’s assistant on the care that should be provided. Some hospitals elect to keep an emergency physician on staff but rely on telemedicine to obtain specialist consults and second opinions.
In Mississippi, emergency telemedicine adoption has been stalled, largely due to a regulation that prohibits doctors from providing emergency telemedicine services to hospitals unless they have previously worked at a Level One Hospital Trauma Center with helicopter support. There is only one such facility in the state. There are many more board-certified emergency physicians who are qualified to provide emergency telemedicine services regardless of where they have worked; the regulation prevents these physicians from offering a much-needed service, thus hindering access to emergency healthcare for a significant portion of Mississippi’s population.
To overcome this roadblock, new, fairer regulations have been proposed to increase access to healthcare by allowing any licensed emergency physician to participate in emergency telemedicine. The Mississippi State Board of Medical Licensure has already approved these regulations; approval from the Occupational Licensing Review Commission is expected in the near future.
Laws and regulations remain one of the major barriers to telemedicine adoption across the nation. Some directives are outdated and cannot keep up with the evolving nature of telemedicine. Scope-of-practice laws have ramifications for telemedicine, and privacy laws, such as HIPAA, control how information is shared between telemedicine platforms. As telemedicine continues to grow and evolve, we must be vigilant and remove or update regulations quickly so that more people can access more healthcare, more easily.
To read more about the Mississippi case, visit the Clarion Ledger here.