By Laura Dickson Rixey
The use of telemedicine services offers many potential benefits to physicians and patients by providing a more convenient, flexible and accessible way to deliver care. Although many practitioners are eager to incorporate telemedicine into their practices, third party payors, regulators, legislators, and licensing boards have struggled with how to apply their laws, rules, and regulations to telemedicine services.
In general, telemedicine services refers to the use of electronic technology or media, including interactive audio or video applications like Skype or FaceTime, for the purpose of diagnosing and treating a patient or consulting with other providers about a patient’s treatment and/or diagnosis. As technology continues to advance and patients continue to seek more convenient and efficient access to care, the use of telemedicine services will become more prevalent. It is estimated that the number of patients using telemedicine services globally will grow from 350,000 in 2013 to seven million by 2018.1 Before utilizing telemedicine services in their practice, practitioners must understand the applicable laws, rules, and regulations under which they must operate.
Since the Virginia General Assembly has not yet established any type of legal framework regarding the provision and delivery of telemedicine services, practitioners must apply existing laws and regulations when delivering telemedicine services. Fortunately, the Virginia Board of Medicine (the “Board”) recently released a guidance document regarding telemedicine to assist practitioners in this evolving area.2
The guidance document clarifies that regardless of the delivery tool or business method used by a practitioner, the practitioner must take appropriate steps to establish the practitioner-patient relationship. Accordingly, the practitioner must conduct all appropriate evaluations and document the patient history consistent with traditional standards of care. Furthermore, the Board has cautioned that “[a] practitioner is discouraged from rendering medical advice and/or care using telemedicine services without (1) fully verifying and authenticating the location and, to the extent possible, confirming the identity of the requesting patient; (2) disclosing and validating the practitioner’s identity and applicable credential(s); and (3) obtaining appropriate consents from requesting patients after disclosures regarding the delivery models and treatment methods or limitations, including any special informed consents regarding the use of telemedicine services.”3
The guidance document also includes telemedicine guidelines the Board has adopted with respect to licensure, evaluation and treatment, informed consent, medical records, privacy and security of patient information, and prescribing practices. For instance, the Board has advised physicians to obtain written evidence documenting a patient’s appropriate and specific informed consent for the use of telemedicine services. The Board has also provided guidance on prescribing medications via telemedicine services and stated that such a practice remains in the professional discretion of the prescribing practitioner and subject to existing laws and regulations.
Before incorporating telemedicine services into your medical practice, physicians should consult the Board’s guidance document so that they fully understand the framework under which they must operate when delivering telemedicine services.
1 Virginia Board of Medicine, Telemedicine, Guidance Document 85-12 (February 19, 2015), available at https://www.dhp.virginia.gov/medicine/medicine_guidelines.htm.
2 Virginia Board of Medicine, Telemedicine, Guidance Document 85-12 (February 19, 2015), available at https://www.dhp.virginia.gov/medicine/medicine_guidelines.htm.
3 Virginia Board of Medicine, Telemedicine, Guidance Document 85-12 (February 19, 2015), available at https://www.dhp.virginia.gov/medicine/medicine_guidelines.htm.
Laura Dickson Rixey is an associate in the Health Care Practice Group at Kaufman & Canoles, P.C. She can be reached at (757) 624.3001 or ldrixey@kaufcan.com.
