Telemedicine and the Role of State Medical Boards

Telepsychiatry via interactive or synchronous video-conferencing, a form of telemedicine, is bound by a broad tapestry of laws and regulations across the United States. Just as each state has its own regulations regarding medical licensure and medical practice for in-person care, the same is true for practicing telemedicine.

Psychiatrists should know how the state statutes and regulations vary between in–person practice and telemedicine practice for each state in which they wish to treat patients. One resource available to psychiatrists in navigating state policy are state medical boards, which are mandated to protect the public's health, safety, and welfare through medical licensing and regulating medical practice.

Collectively, the national association of state medical and osteopathic regulatory boards is the Federation of State Medical Boards (FSMB)1. The FSMB supports individual state medical boards with education, assessment, research and advocacy. The FSMB also provides state member boards with services and initiatives to promote patient safety, quality health care and regulatory best practices. With respect to telepsychiatry, the FSMB has published A Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine (2014)2. The intent of this model policy is to remove regulatory barriers to the appropriate adoption of telemedicine while ensuring public health and safety.

The FSMB model policy holds the same fundamental principles for in–person care and telemedicine care including:

  1. Determining when a physician/patient relationship is established.
  2. Assuring privacy of patient data.
  3. Guaranteeing proper evaluation and treatment of the patient.
  4. Limiting the prescribing and dispensing of certain medications.

The FSMB model policy also expects physicians providing in–person care and telemedicine care to maintain the same degree of professionalism and to:

  • Place the welfare of patients first.
  • Maintain acceptable and appropriate standards of practice.
  • Adhere to recognized ethical codes governing the medical profession.
  • Properly supervise non–physician clinicians.
  • Protect patient confidentiality.

Other useful resources for psychiatrists wishing to learn more about telemedicine practice, state law and regulations include: individual states' medical boards; the American Telemedicine Association State Policy Resource Center3; the Center for Connected Health Policy4; and the American Medical Association5. Your medical malpractice insurance carrier may be a useful resource, as well.

About the Author

Alexander von Hafften M.D., M.S., DFAPA
Member, APA Committee on Telepsychiatry
Assembly Representative, Alaska Psychiatric Association
Adjunct Professor, Alaska WWAMI School of Medical Education

Dr. Hafften previously developed an Alaska-based psychiatry residency with telepsychiatry training and clinical responsibilities.

References

  1. Federation of State Medical Boards at fsmb.org.
  2. Federation of State Medical Boards Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine. April 2014 at http://www.fsmb.org/Media/Default/PDF/FSMB/Advocacy/FSMB_Telemedicine_Policy.pdf
  3. American Telemedicine Association State Policy Resource Center at http://www.americantelemed.org/policy-page/state-policy-resource-center
  4. Center for Connected Health Policy at http://www.telehealthpolicy.us/state-telehealth-laws-and-reimbursement-policies-report
  5. American Medical Association at https://www.ama-assn.org/delivering-care/telemedicine-mobile-apps#Telemedicine

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