AMA telemedicine policy echoes controversial state boards' view

A physician delivering care via telemedicine should be licensed in the state where the patient is located and the same standards of care that apply to traditional healthcare settings should apply to telemedicine, according to policies approved by the American Medical Association House of Delegates at its annual meeting this week in Chicago.

The policies were included as recommendations in a report (PDF) by the AMA Council on Medical Service. The contention that the point of care is the patient's location and not their doctor's matches a similar policy passed recently by the Federation of State Medical Boards. That policy had been criticized as slowing the spread of telemedicine by requiring physicians to go through multiple cumbersome and expensive state license-application processes.

After leading a forum on telemedicine Saturday, Dr. Chuck Willson of North Carolina defended the policy.

“It is cumbersome to companies that want to expand rapidly,” Willson said.

The AMA did yield some ground on one point.

Previously, it had insisted that telemedicine be provided only to patients with whom doctors had at least one face-to-face encounter. But delegates approved the report's recommendation that a telemedicine physician-patient relationship can be established through consultation with a doctor that the patient already has an established relationship with or through standards “included as part of evidence-based clinical practice guidelines on telemedicine developed by major medical specialty societies, such as those of radiology and pathology.”

The goals of the report were to protect the physician-patient relationship, support innovation, ensure patient privacy and quality of care, and promote care coordination and communication with a patient's medical home, Willson noted.

Some form of national licensure has been suggested as an alternative to requiring multiple state licenses for physicians who practice telemedicine. The AMA opposes that concept, but delegates did approve a resolution calling for the AMA to study “issues associated with state-based licensure and portability of state licensure for telemedicine services.”

Delegates asked that a report on this topic be ready for consideration at the House of Delegates interim meeting scheduled for Nov. 8-11 in Dallas.

Follow Andis Robeznieks on Twitter: @MHARobeznieks



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