Telemedicine rules should be reformed


The doctor can see you now. Literally. Telemedicine - the ability of physicians to examine and treat patients remotely, using video conferencing - is increasing throughout the nation, as smart phones have put the necessary technology in the hands of millions of Americans.

Increasing, that is, in states that aren't Texas. Last spring, the Texas Medical Board issued a rule severely limiting the practice of telemedicine. The rule says doctors can't treat patients remotely unless they've already seen them in person.

"Essentially, the new rules would prevent telemedicine firms from operating in Texas in their current form," explain John Davidson and Alison Hern of the Texas Public Policy Foundation, writing in the Austin American-Statesman. "Teladoc, a telemedicine company based in Dallas, filed a lawsuit claiming the rule, if put into effect, would eviscerate their business model and unfairly restrict telemedicine firms from operating in Texas."

A judge has halted the implementation of that rule for now, until that lawsuit is heard.

"If TMB's telemedicine rule is upheld in court, some observers are concerned how it will impede the expansion of telemedicine in Texas, which the Legislature supported in this past session," Davidson and Hern explain.

For example, lawmakers passed a bill regarding telemedicine and EMS.

"In practice, that means ambulances will be equipped with audio-visual technology on a secure Internet connection so EMS personnel can communicate with and transmit medical data to physicians at regional trauma centers when assessing patients in the field," they write.

They're trying it out now in West Texas.

"Under the pilot program, EMS responders will be able to consult a physician in real-time to provide diagnosis and treatment advice while the patient is en route to the trauma center, thus improving a patient's chances of recovery," the authors claim. "If physicians can safely give diagnostic and treatment advice to EMS responders in an emergency, they should be able to do the same for individual patients in a nonemergency."

Telemedicine could do tremendous good for Texas. Like the rest of the country, we're likely facing a worsening physician shortage. There are fewer doctors to treat us, even as the Affordable Care Act has resulted in millions more prospective patients. And as the Baby Boomers continue to age, their medical needs will increase.

Telemedicine could help, by enabling physicians to treat more people in more locations, much more conveniently.

And it's working elsewhere. Many states have better rules for telemedicine and it's flourishing.

"This past spring, the Texas Medical Board justified their new restrictions on telemedicine in part by arguing that it wouldn't be safe for physicians to diagnose or recommend treatment to patients without first having a face-to-face meeting," Davidson and Hern note. "And yet the physicians with whom EMS will be communicating in this pilot program will likely have never seen or treated the patients under EMS care. The fact is, telemedicine … is safe. It is widely practiced in many other states, and Texas should embrace it - not regulate it out of existence."

The Texas Medical Board should reform its rules.

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