Last month, The Federation of State Medical Boards (FSMB) issued new guidelines to serve as a roadmap that state boards can use to establish their telemedicine policies. Among the guidelines is a definition for telemedicine that excludes specific forms of telemedicine. FSMB’s document, titled“Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine“, defines telemedicine as:
“The practice of medicine using electronic communications, information technology or other means between a licensee in one location, and a patient in another location with or without an intervening healthcare provider. Generally, telemedicine is not an audio-only, telephone conversation, e-mail/instant messaging conversation, or fax. 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.” (emphasis added)
The specific exclusion of audio-only communication as well as email, instant messaging, and fax in the definition prompted criticism from the American Telemedicine Association (ATA). In a letter to the FSMB, the ATA acknowledges that the move to video conferencing is important, but it cautions that disallowing telephone consultations would limit the delivery of care. According to the ATA, there are at least three states that cover telephone-based consults under their Medicaid plan. The ATA also said 250,000 telephone-based consultations will be made by two web-based providers alone in 2014. Despite their objections to the new definition, as well as other parts of the guidelines, the ATA expressed appreciation for the efforts of the FSMB to develop a national standard that can be used across the country’s 70 state medical boards. The differences in state telemedicine regulations make it difficult for providers and companies to develop telehealth solutions that extend across state lines.