- Delaware’s Board of Medicine has tightened up its telehealth and telemedicine regulations.
The guidelines touch upon two hot-button issues in telemedicine policy: the use of connected care technology to establish a valid physician-patient relationship, and incorporating telemedicine into new substance abuse programs to tackle the nation’s opioid abuse epidemic.
The new guidelines specify that a valid doctor-patient relationship in telehealth can only be established via a live, real-time audio-visual platform. This eliminates phone-based telehealth services as well as asynchronous or store-and-forward telehealth.
The latter platform, in which patients fill out a questionnaire and send it to a provider for timely review, diagnosis and treatment, is gaining popularity among providers seeking to establish a direct-to-consumer service for non-acute conditions. Several health systems see the asynchronous platform as an ideal means of reducing unnecessary traffic to the hospital ED or doctor’s office and giving consumers a quick and easy path to treatment for such issues as common colds and infections.
While several states have banned telehealth services via phone, fax or e-mail, some providers have argued that an audio-only platform can be beneficial if designed properly. In New Mexico, for instance, two health plans recently launched a phone-based service for some 40,000 members.
“In medicine, if you can listen well and take a good history, you can get a good diagnosis most of the time,” Dr. Kiko Torres, senior medical director of True Health New Mexico, recently told the Albuquerque Journal. “In the case of strep throat, for example, if a patient has a sore throat but they also have significant respiratory-type systems, we know it’s probably not strep. If the case gets to be a little more complex, a patient can be referred to a (brick-and-mortar) clinic.”
In addition, the Delaware board’s new guidelines prohibit the prescription of opioid through telemedicine except in certain addiction treatment programs that use medication assisted therapy (MAT). Those programs can use connected care technology if they’ve received a Division of Substance Abuse and Mental Health (DSAMH) waiver to use telemedicine.
This hews more closely to efforts by legislators and health systems to create a pathway to using telemedicine in innovative substance abuse treatment programs. Of particular interest are programs that enable providers to prescribe certain controlled substances through a telemedicine platform, then use that platform to continue the care program for that patient.
Finally, the Delaware Board of Medicine has clarified what practice guidelines can be used in establishing a telemedicine program. The board has noted that it’s only accepting guidelines from specialty societies that are members of the state’s Council of Medical Specialty Societies.