The Doctor Will See You Now?
Digital technology and mobile applications have changed the face of nearly every service-oriented industry. Mobile health care (mHealth) applications offer access to basic care and routine monitoring anytime, anywhere.
Telemedicine — the use of real-time electronic communications to provide remote clinical services for nonemergency (“nonemergent”) medical questions or for patients unable to visit a primary care facility — is well established. And, there is extensive evidence that telemedicine offers quality care on par with routine in-person visits, is well-received by patients and providers, and delivers considerable cost-savings.
Thus, it is unsurprising that, since 2014, 25 states have revised their professional standards and licensure requirements in response to providers offering health services via telemedicine. Or that, in 2014, the Centers for Medicare and Medicaid Services changed its fee schedule to encourage more telehealth practices.
Yet, in order to protect established providers from competition, medical regulators in some states have tried to severely restrict the use of telemedicine. This is especially the case in Texas.
Grading State Telemedicine Regulations. The American Telemedicine Association awarded 22 states an “A” for regulations governing telemedicine providers-patient encounters. Three states — Texas, Alabama and Arkansas — got an F. As the table illustrates:
- Arkansas and Texas are the only states that require patients to have an
established relationship (that is, an in-person visit) with a physician
prior to a telemedicine encounter.
- Texas, Alabama and Georgia are alone among states in requiring an inoffice
follow-up visit after a telemedicine encounter.
This is striking considering Texas ranks 51 out of 51 (including Washington, D.C.) for access to medical care in the United States.