The American Medical Association (AMA) released their new telemedicine policy last week, following the footsteps of the Federation of State Medical Boards (FSMB), which arrived at its updated model policy a few weeks earlier. The AMA telemedicine policy takes a similar approach to the use of telemedicine, much to the disappointment of the American Telemedicine Association (ATA) and many telehealth advocates.
The new AMA telemedicine rules, like FSMB, has been updated to allow for the establishment of a patient-provider relationship sans face-to-face office visit — a step up for telemedicine. The upset comes over the requirement that initial visits to be in-person, i.e. via real-time video and audio – not an email, phone, or text chat.
This is good news for telehealth companies like MDLIVE, American Well, and Doctor on Demand, which have been gearing up for video chat virtual doctor visits and are ready to go with real-time video visits. It’s not-so-good news for online consultation services that have focused on phone and email telehealth, like Teladoc, Virtuwell, and Zipnosis. Of course, actual governing telehealth laws are still in the hands of the state and are many and varied.
Different Telemedicine Regulations for Different States
According to this American Medical News article, all 50 states allow some form of telemedicine. Beyond requiring that physicians, nurses, and physician assistants be licensed in their home state and in their patients’ states (another sore point of the new AMA telemedicine policy), there is little uniformity in telemedicine regulations. Some states have more stringent laws for practicing telemedicine such as requiring an in-person follow up visit to an initial telemedicine visit. Texas, for example, does not allow prescribing more than 3 days of medication via telemedicine. Others, such as Wisconsin, have no specific laws governing the practice of telemedicine, just as long as you’re licensed in the state.
Although AMA and FSMB’s policy’s are disappointing to some, requiring the initial telemedicine visit to be over video simply reflects the now general acceptance of video telemedicine by states and insurance carriers. While online consultations by phone and email are gaining acceptance, there is still a lot of controversy about its appropriateness . After all, we are still in the early days of telemedicine, and many are concerned about the quality of care delivered with telemedicine. As AMA President Robert Wah made clear, “Whether a patient is seeing his or her physician in person or via telemedicine, the same standards of care must be maintained.”
For a clean, bullet point summary of the new AMA policy and issues, check out this Medlaw blog.