Page 10 - Delaware Medical Journal - July 2017
P. 10
PRESIDENT’S PAGE
Care Coordination/Telehealth program successfully reduced the number of reduction in hospital readmissions all while showing high scores for patient satisfaction. The CHRONIC Cares Act includes coverage for additional telehealth services giving certain accountable care
to provide telehealth services, allowing
treatments to do their monthly check-
in with their doctor via telehealth, and expanding coverage for tele-stroke greenlighted these provisions concluding that they would be budget neutral.
telemedicine can have a disruptive effect on the physician-patient relationship. Episodic care delivered without regular physicians may lead to duplicative care and increased costs. In its position paper on recommendations for the use of telemedicine in primary care published
in the Annals of Internal Medicine in 2015, the American College of Physicians cautions that telemedicine “presents several challenges to maintaining continuity of care and a strong patient- physician relationship.” They developed a number of recommendations some of which include:
• Telemedicine should be used episodically for immediate acute care needs when needed and should not be a replacement for the patient’s primary care physician.
• A valid patient-physician relationship must be established for professionally responsible telemedicine to take
place, noting this relationship could
be established by means of real-time audiovisual technology if not in person.
• Telehealth services should address
the needs of all patients without disadvantaged populations or those with low literacy or low technologic literacy.
• Physicians should determine whether a telemedicine visit is appropriate for a particular patient.
• Telemedicine use should be secure and compliant with federal and state privacy laws.
• Telemedicine visits are held to the same standard as in-person visits.
• Physicians who use telemedicine should be proactive in protecting themselves against liability.
Another issue that affects the telehealth expansion is medical licensure by the state medical boards. The Interstate Medical Licensure Compact (IMLC) offers
an expedited pathway to licensure for
in multiple states. The IMLC mission is to increase access to health care for patients in underserved or rural areas and allowing them to more easily connect with medical experts through the use of telemedicine technologies. While Delaware chose
not to participate in the IMLC when the subject was reviewed two years ago, 20 states have now enacted legislation for physicians to participate in this compact. The American Telemedicine Association (ATA), an advocacy organization developed with the goal of increasing
use of telemedicine services, strongly supports this compact. It was not long ago that the ATA gave Delaware a letter grade of “F” with regards to telemedicine in terms of coverage and reimbursement, physician practice standards, and licensure. Since our legislation has been enacted, the ATA has upgraded Delaware to a letter “B.” However, we should bear in mind that the ATA is also comprised of telehealth/telemedicine vendors and there continues to be ongoing tension between practitioners who want better continuity of care for their patients and have concerns regarding direct to consumer marketing without quality assurance.
Our MSD continues to advocate for the responsible use of telehealth and telemedicine services to assure proper physician utilization and the safety
of our patients. Our Health Hub, LLC subsidiary is now vetting telemedicine products and vendors and soon hopes to make recommendations to those physicians who are considering this technology for their practice. I am proud of the important work our MSD physician volunteers are doing on behalf of all physicians in the state and wish to thank them for their efforts. and informative. Thank you for your continued participation and support.
Prayus Tailor, M.D.
President, Medical Society of Delaware
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Del Med J | July 2017 | Vol. 89 | No. 7
