When it comes to technology-based opportunities to fill the gaps along the continuum of care, telemedicine is top of mind for many healthcare stakeholders. To help achieve the goal, policymakers in a number of states have been searching for an appropriate balance between enabling telemedicine opportunities and protecting the quality of patient care.
But the different outcomes to those legislative processes reveal the underlying tension that can emerge between the desire to take advantage of telemedicine’s extended reach, the need to facilitate that reach with effective reimbursement models and the imperative to protect patient safety.
Earlier this month the Texas Medical Board voted to accept rule changes that would prohibit physicians licensed in Texas from prescribing medications over the telephone to a patient they had never met before. The ruling was applauded by the Texas Medical Association, which released a statement saying the physicians’ group “‘supports the use of telemedicine that can provide safe, high-quality, timely care,’ but that safeguards must be in place ‘to protect patients and ensure telemedicine complements the efforts of local health care providers.’”
Not surprisingly, telemedicine provider Teladoc called the ruling “a huge step backward for Texas, (that would eliminate) a safe, affordable and convenient health care option that many have depended on for more than a decade.”
Meanwhile, at the other end of the spectrum, in Washington, the state legislature passed a bill that requires insurance companies to pay providers for telemedicine services at similar levels to the reimbursements for comparable services if they had been provided in person. This legislation has the potential to pave a clear path for expansion of telemedicine by physicians and mental health professionals in the state, especially in rural regions.
And, in between, there’s Iowa, where, according to an article in the Cedar Rapids Gazette, “there’s been a flurry of activity in recent weeks involving telemedicine adoption and regulation in Iowa, including new rules out by the Iowa Board of Medicine, the licensing and regulating body for the state's physicians; failed legislation at the state legislature; and a pending ruling from the Iowa Supreme Court regarding telemedicine abortions.”
Correctly dubbing the effective regulation of telemedicine “complicated,” the article lists numerous obstacles standing “in the way of greater adoption, including lack of physician and patient familiarity, low insurance reimbursement rates, and the need for better infrastructure.”
Taken together, these stories paint a good picture of the stop-and-start nature of the challenges surrounding many health IT developments. Unlike other industries, the efficiencies expected with the introduction of new technology aren’t simply a matter of a healthier bottom line. Lawmakers at the federal and local level can speed or slow the progress.