School of Medicine and Health Sciences Poster Presentations
Poster Number
246
Document Type
Poster
Status
Medical Student
Abstract Category
Health Policy and Management
Keywords
Telemedicine, Cross-border tele-medicine, Law, Europe
Publication Date
Spring 2018
Abstract
Despite the fact that there have been many advances in the field of telemedicine, the United States (U.S.) state and federal laws have not kept pace with these technological advancements and may operate as a barrier to growth in the field of telemedicine. On the other hand, the European Union (EU) has developed a robust legal framework for the practice of telemedicine. The aim of this research project is to evaluate what elements of the EU legal experience could be used to support efforts to better align telemedicine law with the practice of telemedicine in the U.S.
Based on the 2015 EU Guidelines, by 2020, a French physician may be able to see a German patient online and have instant access to the patient’s medical record, automatically translated into the French language.1 The EU has prioritized the creation of a legal framework that fully supports cross-border telemedicine.2 As early as 2000, the EU broadened medical licensure requirements for telemedicine so that physicians licensed in one nation could provide telemedicine services to patients who reside in other EU nations without needing to obtain medical licenses from these nations.3 Furthermore, linguistic experts from several nations of the EU have been working together to develop ways of automatically translating and instantly delivering patient records to physicians as appropriate.1
The state medical boards of the U.S, however, have struggled with efforts designed to achieve similar legislative changes. In most states, physicians are required to be licensed in both the state where they practice and the state where the patient resides.4 For example, a Texas physician is required to obtain a Georgia medical license in advance of providing telemedicine care to a patient in Georgia to ensure that their services are legal and reimbursable by insurance.4 While some states now provide a telemedicine license or expedite multistate licensing, these measures are insufficient to support the widespread practice of interstate telemedicine.4 With current regulations, obtaining medical licenses in all 50 states for telemedicine practice is impractical and prohibitively expensive for healthcare providers and organizations.
U.S. medical licensure requirements for telemedicine practice are comparable to EU regulations before 2000. Furthermore, U.S. telemedicine reimbursement regulations arbitrarily differ across state borders, and electronic medical record systems from various companies do not communicate properly with each other. At this time, physicians in the U.S. cannot retrieve patient records for unscheduled patient encounters in real-time unless the patient was previously treated using the same medical health records system, causing inconvenience to patients, treatment delays and duplicative medical testing.5
Similar to the European approach, we recommend that the state medical boards allow physicians licensed in one state to provide telemedicine services to patients in other states. Furthermore, we recommend collaboration among the state medical boards, industry leaders, and state legislatures to come up with uniform telemedicine reimbursement regulations and to design a uniform electronic medical record inter-operability standard to allow the U.S. telemedicine industry to keep abreast of the global developments in telemedicine,
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Open Access
1
How the European Union Is Embracing Cross-border Telemedicine and what the U.S. State Medical Boards Can Learn From It
Despite the fact that there have been many advances in the field of telemedicine, the United States (U.S.) state and federal laws have not kept pace with these technological advancements and may operate as a barrier to growth in the field of telemedicine. On the other hand, the European Union (EU) has developed a robust legal framework for the practice of telemedicine. The aim of this research project is to evaluate what elements of the EU legal experience could be used to support efforts to better align telemedicine law with the practice of telemedicine in the U.S.
Based on the 2015 EU Guidelines, by 2020, a French physician may be able to see a German patient online and have instant access to the patient’s medical record, automatically translated into the French language.1 The EU has prioritized the creation of a legal framework that fully supports cross-border telemedicine.2 As early as 2000, the EU broadened medical licensure requirements for telemedicine so that physicians licensed in one nation could provide telemedicine services to patients who reside in other EU nations without needing to obtain medical licenses from these nations.3 Furthermore, linguistic experts from several nations of the EU have been working together to develop ways of automatically translating and instantly delivering patient records to physicians as appropriate.1
The state medical boards of the U.S, however, have struggled with efforts designed to achieve similar legislative changes. In most states, physicians are required to be licensed in both the state where they practice and the state where the patient resides.4 For example, a Texas physician is required to obtain a Georgia medical license in advance of providing telemedicine care to a patient in Georgia to ensure that their services are legal and reimbursable by insurance.4 While some states now provide a telemedicine license or expedite multistate licensing, these measures are insufficient to support the widespread practice of interstate telemedicine.4 With current regulations, obtaining medical licenses in all 50 states for telemedicine practice is impractical and prohibitively expensive for healthcare providers and organizations.
U.S. medical licensure requirements for telemedicine practice are comparable to EU regulations before 2000. Furthermore, U.S. telemedicine reimbursement regulations arbitrarily differ across state borders, and electronic medical record systems from various companies do not communicate properly with each other. At this time, physicians in the U.S. cannot retrieve patient records for unscheduled patient encounters in real-time unless the patient was previously treated using the same medical health records system, causing inconvenience to patients, treatment delays and duplicative medical testing.5
Similar to the European approach, we recommend that the state medical boards allow physicians licensed in one state to provide telemedicine services to patients in other states. Furthermore, we recommend collaboration among the state medical boards, industry leaders, and state legislatures to come up with uniform telemedicine reimbursement regulations and to design a uniform electronic medical record inter-operability standard to allow the U.S. telemedicine industry to keep abreast of the global developments in telemedicine,
Comments
Presented at GW Annual Research Days 2018.