As 2018 drew to a close, there was plenty of news related to telemedicine. Six different states had headlines that highlight some of the trends, and controversies surrounding this modern approach to healthcare. Here are some of the ones we found most important.
Kansas Extends Its Medical Board’s Regulations to Telemedicine
According to the Associated Press, Kansas has extended the state medical board’s existing regulations for health care providers to the practice of video consultations with patients. The approval of the temporary rules drafted by the State Board of Healing Arts was unanimous and will take effect in January. This is good news for Kansas patients and providers as the new law encourages the use of telemedicine, especially in areas where there is a shortage of healthcare providers, by ensuring that private payers reimburse physicians for such services.
The temporary regulations will remain in effect for four months, with a public hearing on the issue of similar permanent provisions occurring in March.
Tennessee Law Allows for Telemedicine Across State Lines
Tennessee has joined the Interstate Medical Licensure Compact, which includes about half of the states. Starting Jan. 1, Tennessee doctors have a simpler way to practice in other states, and out-of-state doctors will get the same treatment in Tennessee. Through the compact commission, doctors have to apply and pay fees to get a license in each state they wish to practice in, but the paperwork is much less cumbersome than before
“The states who are entering this compact have a good understanding of what those requirements are and are comfortable with that being adequate,” says Dave Chaney, vice president of the Tennessee Medical Association.
A New Mexico Bill Adds Telemedicine to Assisted Suicide Debate
Proposed legislation in New Mexico would allow qualified healthcare providers to use telemedicine to assess a patient’s ability to request physician-assisted suicide. The proposed law creates a strict protocol for assisted suicide, which includes a 48-hour waiting period after a prescription for end-of-life drugs. It also contains drafts of a letter of consent for the patient and the provider and allows providers to refuse to take part in the process. Further, it mandates that all signed wills, contracts, and life insurance policies not be affected by the patient’s decision to die, and requires that the cause of death be listed as the patient’s “underlying terminal illness.”
The measure is controversial. Previous attempts to allow for physician-assisted suicide in New Mexico have not been successful in the legislature or the courts. However, the outcome this time might be different with several cities and the state’s new governor, Michelle Lujan Grisham, signaling support for a person’s right to choose to die.
Michigan Governor Vetoes Extension of Telemedicine Abortion Ban
Speaking of controversial uses of telemedicine, Michigan’s Gov. Bill Snyder has vetoed SB 1198, which would have indefinitely extended a 2012 law prohibiting physicians from using telemedicine to prescribe drugs used to cause an abortion.
The Michigan legislator passed a law in 2012 that requires physicians to conduct an in-person exam before prescribing any medication that would end a pregnancy. It also requires that the physician be present when those medications are administered. That law was scheduled to expire at the end of 2018, but the Legislature passed SB 1998 to extend that ban indefinitely. The legislation also banned the use of telemedicine to diagnose a pregnancy.
In explaining his veto, Gov. Snyder said, “Telemedicine allows a physician to prescribe and dispense medication by video or teleconference. Objective research shows that medical abortions are safe and that a virtual consultation with a physician is as effective as in-person consultation with a physician.”
A New Study Finds that Minnesota Telemedicine Visits Are Up by 40%
A first-of-its-kind report used a Minnesota database of health insurance claims to discover that the number of telemedicine visits increased seven times from 2010 to 2015. The study is part of a special edition of the journal Health Affairs that assesses the national impact of telemedicine.
Most of the increase was in virtual visits by privately insured patients in metro areas, who used online portals to receive routine care for sore throats and skin rashes. Half the telemedicine visits were completed by nurse practitioners or physician assistants — almost 20% involved psychiatrists who assessed patients or updated their medication or treatment regimens.
Telemedicine Demand Emphasizes the Need for Rural Broadband in Texas
Rural areas have long suffered from the lack of broadband connectivity in Texas. But the demand for telemedicine, which can improve access to care for poor, rural areas with few clinicians, is renewing state and federal efforts to improve internet infrastructure in the state.
In 2018, Texas lawmakers passed bills that made telemedicine legal and improved the reimbursement process to help rural counties contend with provider shortages and hospital closures. When they convene in 2019, the legislature will address bills to help rural areas get connected to high-speed Internet services.
Blake Hutson, associate state director for advocacy at AARP Texas, explained, “We definitely see broadband as big barrier. A lot of cutting-edge concepts in telemedicine are not available to people in rural areas.” The chief obstacle for rural providers is the cost of laying lines, which the new legislation will seek to address.
As these stories illustrate, the landscape for telemedicine in the US continues to evolve. Many states are working toward expanding the use of telemedicine as a way to address the evolving needs of their citizens.