- Telemedicine vendors in Arkansas will have to reevaluate their business plans after the state’s House of Representatives quashed a proposal allowing private companies to enlist licensed Arkansas physicians to deliver remote care. House Bill 1747, championed by Republican Representative Dan Sullivan, was defeated 49-21 in a vote on Friday after some lawmakers worried that the legislation would be detrimental to patient care instead of helpful.
“Despite continuous efforts to encourage and develop access to health care in all areas of our state, many of our citizens still face critical barriers and are an underserved sector as it pertains to meaningful access for appropriate primary health care when it is needed,” the bill said. Lack of access to primary care and follow-up after hospitalization may lead to the development or poor management of chronic disease, increased complications, higher healthcare costs, and downstream economic impacts across the state, the legislation continues.
But lawmakers were largely unconvinced by the proposition to allow private telehealth service providers to utilize the state’s physician workforce to bring interactive video conferencing to the state’s patients, many of whom live in rural areas.
"It certainly is an exciting time in medicine…but I think we need to slow this process down," countered Rep. Stephen Magie, D-Conway, speaking to Arkansas Online about his concerns that expanding telemedicine would lead some patients to turn to video chats when they should see a physician in person. "Just because it costs less doesn't mean it's good medicine. It may sound good, but I think in the long term it's going to sell our patients short."
The defeated bill would have required the establishment of a “professional relationship” between the patient and provider before the practitioner could diagnose, treat, or prescribe medications to the patient, but the relationship can be established through the internet if necessary. The rule stops short of stating that patients must engage in a face-to-face visit before any telemedicine services can be delivered. That provision is included, however, in a similar telehealth bill coming up through the state Senate, following in the footsteps of several other states.
The in-person relationship clause is intended to foster a connection to primary care, but it significantly reduces the convenience factor for patients who turn to telehealth precisely because they cannot maintain regular and sustained contact with the traditional healthcare system. States such as Georgia believe the primary care relationship should remain at the center of all patients’ care decisions, while California has prevented health insurance companies from mandating an in-person visit before telemedicine can be delivered, and Colorado has been taking steps to do the same.
“The shift to telemedicine is inevitable,” said Mario Gutierrez, the Executive Director of the Center for Connected Health Policy. “This is not a fringe technology. It is very much in the mainstream. “Change is coming state to state with leadership. In states where there is real leadership that understands telehealth and sees the benefit of the technology and can make the case for embracing the technology, you see great change.”