Telehealth offers significant gains in accessibility for patients who live in . remote areas without access to primary care and/or sspecialty care. Despite these advantages regulations differ in each state. Health care reform in the ACA and future iteratioins has given insurance coverage to millions of more Americans. Coverage however does not guarrantee access to a physician.
Some adaptations already include the addition of nurse practitioners who are licensed to work independently. Their training is now standardized and many practice in a physician supervised clnic. However some work in rural and remote locations, requiring communication with a physician. Telemedicine offers the ability to share images, diagnostic images from otoscopes, ophthalmoscopes, and dermatology images, even with magnification. An ongoing interactive session adds to the NPs knowledge for a particular case. Remote imaging is widely used for screening of diabetic retinopathy.
State regulators and state medical boards who advise legislators have uppermost in mind the efficacy, reliablity and safety of this technology. Medical boards have already prescribed courses and limitations in guidelines for using telemedicine. These are easily found elsewhere in the guidelines form the American Telemedicine Association.
The Federation of State Medical Boards (FSMB) Chair, Jon V. Thomas, MD, MBA, appointed the State Medical Boards’ Appropriate Regulation of Telemedicine (SMART) Workgroup to review the “Model Guidelines for the Appropriate Use of the Internet in Medical Practice” (HOD 2002)1 and other existing FSMB policies on telemedicine and to offer recommendations to state medical and osteopathic boards (hereinafter referred to as “medical boards” and/or “boards”) based on a thorough review of recent advances in technology and the appropriate balance between enabling access to care while ensuring patient safety. The Workgroup was charged with guiding the development of model guidelines for use by state medical boards in evaluating the appropriateness of care as related to the use of telemedicine, or the practice of medicine using electronic communication, information technology or other means, between a physician in one location and a patient in another location with or without an intervening health care provider.
MODEL POLICY FOR THE APPROPRIATE USE OF
TELEMEDICINE TECHNOLOGIES IN THE PRACTICE OF
MEDICINE
Report of the State Medical Boards’ Appropriate Regulation of
Telemedicine (SMART) Workgroup
Adopted as policy by the Federation of State Medical Boards in April 2014
Given the rapidity of change in Health 3.0 regulations will not remain statics as HIT evolves further.
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