New telemedicine guidelines emphasize video, rather than audio

The Federation of State Medical Boards (FSMB) has issued new guidelines for the use of telemedicine, but some of the provisions, including the board’s definition of telemedicine, have prompted criticism from the American Telemedicine Association (ATA).

The new guidelines stress the need for physicians to communicate with patients through video, rather than only audio or email.

“Generally, telemedicine is not an audio-only, telephone conversation, e-mail/instant messaging conversation, or fax,” the guidelines state. “It typically involves the application of secure videoconferencing, or store-and-forward technology to provide or support healthcare delivery by replicating the interaction of a traditional, encounter in person between a provider and a patient.”

In a letter sent to the FSMB before the guidelines were approved, the ATA acknowledged that video may be more of a benefit to patient safety. However, it cautioned against using such a loose definition for telemedicine.

“The fact remains that the telephone is an important tool for current patient interactions. This year it is estimated that approximately 250,000 telephone-based consultations will be made by two web-based providers alone,” the letter stated. “Use of the word ‘generally’ in the existing language does not clarify the problem of a rigid policy disallowing any use of telephones or emails as telemedicine. State policies that prohibit any such use could set back the practice of medicine and significantly limit the delivery of care.”

The number of physicians using telemedicine to diagnose and treat patients is growing at a rapid pace. More than half of all hospitals in the U.S. use a form of telemedicine, according to the ATA.

The guidelines released by the FSMB are designed to provide states a framework to use when creating their own telemedicine laws.

The FSMB guidelines cover:

• evaluation and treatment of the patient,

• informed consent,

• continuity of care,

• referrals for emergency services,

• medical records,

• privacy and security of patient records and exchange information,

• disclosures and functionality on online services making available telemedicine technologies, and

• prescribing.