Q&A: Navigating the telemedicine requirements

Editor’s note: This is the first year that Medicaid in all 50 states has adopted some form of telemedicine coverage. While technology has allowed for new and creative ways to connect patients and providers, deciphering the laws surrounding them can be difficult. The rules for what we can use telemedicine for and where vary greatly on a state by state level. The following is an edited Q&A with Sue Dill Calloway, RN, Esq., AD, BA, BSN, MSN, JD, CPHRM, CCMSCP, president of Patient Safety and Healthcare Consulting and Education, on the need to know about telemedicine. 

BOAQ: What are the pros and cons of telemedicine? And what research has been done on this topic?
Calloway: There are many pros to using telemedicine and I really think this will be the wave of the future. Telemedicine can bring state of the art medicine to the most remote places in the country. A patient can be treated in their own community as opposed to long travels. It will become more prevalent with the projected physician shortage. You will see a lot of pros listed in The Joint Commission’s press release or the CMS press release that was issued May 2, 2011. It can save hospitals time and money in the credentialing and privileging process.

It mentions also how beneficial it will be to small rural hospitals and critical access hospitals in rural or remote areas that lack staff or resources to deliver specialized clinical expertise to their patient population.

BOAQ: Do you foresee more states joining the Interstate Licensing Compact in the next 10 years? And what would be the benefits/downsides of this?  
Calloway: Yes, I do. Especially as the barriers to reimbursement are whittled away and the use becomes much more frequent. You might check with the Federation of State Medical Boards for more information. The last time I looked there were 17 states with interstate licensing compacts initiated by them. They also have a model policy for the appropriate use of telemedicine technologies in the practice of telemedicine.

BOAQ: When researching telemedicine information, how would you recommend organizations proceed (assuming they start with CMS’ Conditions of Participation)? 
Calloway: Literature searches are a good place to start and to look for evidence-based guidelines. The American Telemedicine Association is a good place to start. They are promulgating many standards and their website is www.americantelemed.org/ They have a section on their website that lists the telemedicine guidelines. They also have a state by state report on telemedicine.

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