Medical boards receive advice on setting rules for telemedicine

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With the COVID-19 pandemic making telemedicine a household word, the Federation of State Medical Boards (FSMB) has updated its Telemedicine Policy (PDF) for the first time in nearly a decade. The policy addresses areas such as licensure, standards of care, and equitable access to telemedicine.

“What FSMB has been trying to do here is strike that balance between making sure we open up and create space for innovation for good telehealth and trying to discourage the massive growth of things… that cause harm or exacerbate inequality,” Jack Resneck Jr., MD, said during an AMA webinar in early June on the future of telemedicine that was taped ahead of his inauguration as president of the AMA at the 2022 AMA Annual Meeting.

Support for telehealth is a central part of the AMA’s recovery plan for American doctors. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And WADA is ready.

Telehealth is critical to the future of healthcare, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure the sustainability of the practice of doctors and fair payment.

Dr. Resneck was also part of the FSMB working group responsible for evaluating the federation’s telemedicine policy. The task force report led to the policy which the FSMB House of Delegates unanimously adopted in April.

Here are some highlights of the newly adopted FSMB policy.

Telemedecine is only one component of the practice of medicine and some exceptions may allow telemedicine across state lines without a physician being licensed in the state where the patient is located. Exceptions include physician-to-physician consultations, prospective patient screening for complex referrals, episodic follow-up care for established patients, follow-up after travel for surgical/medical treatment, and clinical trials.

“What we’ve tried to do is remove some of the obvious barriers or restrictions that prevent a doctor from caring for their own patients,” FSMB advocacy officer Lisa Robin said during the webinar, which is part of of WADA. Advocacy Insights webinar series.

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The standard of care and professional ethics that apply to in-person visits also apply to telemedicine visits. Failure to adhere to the appropriate standard of care or professional ethics when using telemedicine may result in the sanctioning of a physician by the medical board.

“It’s still medicine. It’s just delivered through a different modality; therefore, the same standard of care and professional ethics will apply,” said Shawn P. Parker, FSMB Board Member and Telemedicine Task Force Leader, during the webinar.

Telemedicine can improve access and reduce inequalities in the delivery of health care when used and deployed effectively. For this to happen, barriers, including gaps in literacy, access to high-speed internet, and coverage and payment for telemedicine services, must be eliminated or reduced.

The FSMB policy calls on physicians, health systems and others to develop education and training information for patient groups whose digital literacy and access are known to be limited. It also urges state governments to pursue policies to expand broadband access and that health plans cover the cost of health care services provided through telemedicine on the same basis and to the same extent as the carrier does this for in-person care.

Find out how the AMA’s advocacy efforts are driving permanent progress in telehealth.

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Next steps

The new policy will help guide state medical boards in regulating the use of telemedicine in the practice of medicine. It also educates licensees and patients about appropriate standards of care.

In a letter to the FSMB, AMA Executive Vice President and CEO James L. Madara, MD expressed “strong support” for the telemedicine policy. He called it “forward-thinking and grounded in the realities of current medical practice.”

Dr. Madara noted that the updated FSMB policy is aligned with the AMA’s recently updated telehealth policies, including flexibilities that promote continuity of care, allow patients to have an initial consultation by through doctor-to-doctor consultations or allow for prospective screening of patients by a specialist.

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