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Telehealth Licensure Compact Goes Live for Physical Therapists

10 states have signed on to the licensure compact, paving the way for physical therapists to launch telehealth platforms in multiple states. A similar licensing compact for physicians is also live, and one for nurses may not be far behind.

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- Physical therapists in 10 states will soon be able to use telehealth to expand their practices and give consumers more access to mobile healthcare services.

Washington Gov. Jay Inslee’s signature on HB 1278 this week means 10 states have signed onto the Physical Therapy Licensure Compact, overseen by the Federation of State Boards for Physical Therapy (FSBPT). The compact makes it easier for therapists to be licensed in member states.

Washington joins Oregon, Montana, North Dakota, Utah, Arizona, Missouri, Kentucky, Tennessee and Mississippi as compact members. Five states – New Hampshire, North Carolina, Colorado, Oklahoma and Texas – have seen compact legislation approved in one legislative chamber so far, and another three – Illinois, Florida and New Jersey – have introduced legislation.

FSBPT officials say the member state will begin processing PT license applications as soon as Compact Commission, composed of officials from the member states, meets to develop bylaws and guidelines for implementation.

This news follows on the heels of last week’s activation of the Federation of State Medical Boards’ Interstate Medical Licensure Compact for physicians, and the announcement that the first license has been approved. Some 19 states have signed onto the IMLC.

Healthcare providers have long seen licensure as a barrier to telehealth and telemedicine expansion, both for health systems looking to create multi-state telehealth platforms and practitioners wanting to expand their patient base – as well as for patients having problems accessing those services.

“Many providers on the phone with a patient don’t ask the question, ‘Where are you at?’” Elliot Vice, director of governmental affairs for the National Council of State Boards of Nursing (NCBSN), which is seeking its own compact, said during a session at the American Telemedicine Association’s Fall Forum last October in New Orleans. “What we’re trying to do is put in a legal structure that facilitates” telehealth and makes that question unnecessary.

Among the organizations backing a licensing compact for physical therapists is the American Telemedicine Association.

“For telemedicine to achieve its maximum potential nationwide, physical therapists must be able to practice at the top of their scope across the barriers of geography,” Jonathan Linkous, the ATA’s CEO, said in a Jan. 27, 2016 letter to William A. Hatherill, his counterpart at the FSBPT. “Passage of the compact will empower physical therapists to participate in and benefit from a variety of innovative service delivery models featuring a multi-disciplinary team approach to provide and coordinate a patient’s care. Patients will reap the ultimate rewards of these efforts.”

“We believe that the structure and tenets of the Physical Therapy Licensure Compact provide the checks and balances to ensure enhanced access to the qualified mental health workforce in our country,” Linkous continued. “At the same time, the compact will provide a multi-state licensing framework for other health professionals using advanced technologies.”

The compact is also expected to ease the process for health systems looking to incorporate telehealth-based physical therapy programs into post-discharge care plans. One such program is the subject of a study by Duke’s University’s Clinical Research Institute.

Launched late last year, VERITAS (Virtual Exercise Rehabilitation In-home Therapy: A Research Study), is designed to evaluate patients undergoing total knee replacement (TKR) surgery who use the VERA virtual exercise rehabilitation platform developed by San Diego-based Reflexion Health, both before and after surgery. They’ll be compared to a control group who receive traditional home- and clinic-based PT.

“Physical therapy is often a critical component of care for patients who have TKR surgery,” Janet Prvu Bettger, ScD, an associate professor with the Duke Department of Orthopaedic Surgery and principal investigator for the study, said in a November 2016 press release announcing the study. “Digital health technology, including virtual and telehealth options, may increase access, improve quality and lower healthcare costs.”

“Extending the reach of physical therapists into the home using a digital healthcare platform like VERA can provide remote guidance and supervision for a home-based therapy program,” she added. “However, implementation in the U.S. has not been widely evaluated until now.”

While compacts have now gone live for physical therapists and physicians, the NCSBN is hoping its Enhanced Nurse Licensure Compact also becomes a reality this year.

Nebraska and West Virginia signaled their acceptance of the nurses’ compact this week, bringing the total to 18 member states. Three states – Georgia, Maryland and Montana – have bills awaiting their governor’s signature, and 10 more states have legislation pending. Ratification is needed in 26 states to trigger the compact.

Proponents of the nurses’ compact “continue to be optimistic about the prospects of reaching the 26-state threshold to trigger this year,” the NCBSN’s Vice told Politico this week.

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