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North Dakota Medical Board Releases New Telehealth Guidelines

The telehealth guidelines established by the medical board in North Dakota focus more on the quality of services rendered than the technical processes through which virtual care is provided.

By Vera Gruessner

- Telemedicine legislation continues to evolve throughout the nation as quickly as healthcare reforms have been implemented and spread across the healthcare continuum. For example, the North Dakota Board of Medicine has issued some telehealth guidelines and regulations aimed at making the state more receptive to telemedicine use, according to The National Law Review.

Telemedicine Technology Regulations

The telehealth guidelines established by the medical board in North Dakota focus more on the quality of services rendered than the technical processes through which virtual care is provided. At this point in time, the medical board has been soliciting public comments and feedback regarding the telehealth guidelines and will meet on November 29 to discuss and review these comments, The National Law Review reports.

It is important for hospitals, tech companies, and other healthcare providers in North Dakota to look over the issued telehealth guidelines and ensure their services comply with the stipulations within the new regulations.

The first important topic to address in the North Dakota telehealth guidelines is the importance of physician licensing. Telemedicine must be practiced by physicians who are licensed in the state that the patient receiving virtual care is located.

This essentially means that doctors providing any type of medical care in North Dakota must be licensed in that state. However, some statutory licensure exemptions are offered in the state.

One statute in the new telehealth guidelines and regulations may actually inhibit the spread of telemedicine and not adhere to the true nature of virtual care. Any telemedicine provider must have a physician-patient relationship established before beginning to diagnose or offering a treatment recommendation via telehealth.

“North Dakota’s definition of telemedicine includes direct interactive patient encounters as well as asynchronous store-and-forward technologies and remote monitoring,” according to The National Law Review.

“Certain types of telemedicine utilizing asynchronous store-and-forward technology or electronic monitoring, such as tele-radiology or ICU monitoring, do not necessarily require an independent examination of the patient to be performed. However, an examination or evaluation that consists only of a static online questionnaire or an audio conversation will not be considered to meet the standard of care.”

Also, the telehealth guidelines focus on ensuring telehealth technology “provides a doctor with information that is equal or superior to an in-person examination.” This may be a more complex stipulation for physicians and information technology experts to meet.

One area in which little guidance is offered is regarding patient medical records. The telehealth guidelines do not require any telemedicine-based recordkeeping stipulations. General North Dakota laws regarding medical records and their upkeep among medical providers treating the patient will need to be followed.

Additionally, providers who’ve conducted a thorough examination via telehealth and came up with a diagnosis are allowed to use remote, electronic prescribing to assign most medications. The one exception is that doctors are not allowed to prescribe opioids for pain relief using telehealth technology.

The ERISA Industry Committee sent a letter to the North Dakota Board of Medicine in which it applauded the medical board for establishing these telehealth guidelines and rulings meant to expand the use of telemedicine technology.

“On behalf of The ERISA Industry Committee (ERIC), we want to thank you for thoughtfully developing your rules to maximize the benefits of telemedicine, and to take this opportunity to express large employers’ interests on this issue,” the letter begins.

“Our members need consistent telemedicine policies around the country so that their workers and their families can enjoy the same company benefits regardless of the state in which they live or work.”

“ERIC agrees with the Board that the standards governing in-person visits should apply in the same manner to telemedicine visits. In other words, there should not be artificial barriers that unnecessarily limit access to medical services provided through telemedicine when there are existing requirements in place to hold providers to high standards of care.”


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