Joseph Kvedar: Telehealth needs standards of care, safeguards

Telehealth is growing more prevalent and states must adopt policies--such as a model policy adopted in April by the Federation of State Medical Boards--to address patient safety, Joseph C. Kvedar, M.D., founder and director of the Boston-based Partners' Center for Connected Health, writes in a Health Affairs blog post. 

"This model policy allows for regulatory certainty while encouraging future innovation by creating clear definitions and guidelines on how and when telehealth can be most effectively incorporated into quality patient care," Kvedar (pictured) writes.

It includes these key principles:

  • Standardizing evaluation and treatment of patient.  Treatment delivered in an online setting should be held to the same standard of appropriate practice as those in traditional settings. The American Telemedicine Association had argued that, in fact, the model policy set the bar higher, putting up barriers to remote care.
  • Establishing a treatment relationship online. A physician-patient relationship can be established using telemedicine, so long as the standard of care is met.
  • Putting online prescribing safeguards in place. In telehealth, prescribing should be at the discretion of the physician.
  • Ensuring privacy, security, documentation and continuity. Telehealth encounters should be HIPAA compliant, include informed consent, the generation of a medical record and support continuity of care.

The model policy is part of an attempt to standardize the practice of telehealth, now governed by a mishmash of state laws. A bill introduced in the U.S. House has a similar goal.

Kvedar points out that as of March, 20 states and the District of Columbia require reimbursement for telehealth services and 46 states offer some type of Medicaid reimbursement.

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