As the world changes, our regulations and laws often scramble to keep up.
Whether it’s Uber being challenged in individual cities or schools struggling to adapt to children owning cellphones, the legal side of life often lags behind our technology, our culture, and our needs.
So it shouldn’t be surprising that telehealth regulations face similar challenges across states — but the consequences are indeed challenging for those who do direct-to-patient telehealth.
A recent article in Fierce Healthcare looked at a few examples of recent telehealth challenges arising from state-to-state regulatory differences.
As they report, “Whether a medical professional can treat someone via telehealth—and if so, how—varies widely by jurisdiction, since medical practice is regulated at the state level.”
For instance, court cases involving doctors seeing patients via telehealth touched on:
- The administration of medical abortions
- Prescription of controlled substances
Further, doctors and patients often run into challenges when the intended telehealth patient didn’t have access to the Broadband internet needed to access an electronic visit with a doctor (thus limiting care in the very places that telemedicine could be most useful.)
These challenges are real, and important to explore. That said, it's not necessarily the case that the challenges are inherent in using telemedicine across state borders.
The regulatory issues presented in the Fierce Healthcare article all boil down to the challenges inherent in a doctor seeing a patient electronically. But “telehealth” is NOT synonymous with doctor-to-patient online visits. As we’ve written about extensively, the umbrella term "telehealth" includes the use of many different kinds of technology to care for patients. A doctor seeing a patient via an online platform is only one version of that.
In fact, the challenges of videoconferencing or electronic visits are the very reasons that we created iClickCare to revolve around medical collaboration among healthcare providers, NOT between a single medical provider and a patient. There are many reasons that a short, technology-supported visit between a healthcare provider and a patient via videoconferencing may not be adequate to provide strong, holistic care of that patient. There isn't a useful archive of the visit; other members of the care team can't be involved; there is often little longitudinal knowledge of the patient; and care is infrequently holistic. The regulatory issues inherent in a “visit” like that are only one aspect of the shortcomings involved.
As an alternative, telemedicine-based medical collaboration allows providers — regardless of location — to collaborate on a case. It also means that if a provider in California is consulting with a provider in New York about a patient in California, the provider in California remains responsible for that patient. And that is “responsible” in all senses, legally and otherwise. Telemedicine-supported medical collaboration allows the flexibility and location independence that telehealth promises. But it doesn’t put the sole responsibility for a patient in the hands of a provider who is 300 miles away and has interacted with them, once, on Skype.
As we step forward into this new age of telehealth, telemedicine, and technology, it's important that we don't simply replace our old system (one-on-one doctors' visits, for instance) with a technological version of that old system. Our patients deserve more imagination than that. And we deserve the ease that can come from a tool that really works to help us deliver great care.