AMA Approves Recommendations for Telemedicine

A valid patient-physician relationship must be established before providing telemedicine services, through a face-to-face examination, if a face-to-face encounter would otherwise be required in the provision of the same service not delivered via telemedicine; a consultation with another physician who has an ongoing relationship with the patient; or meeting standards of establishing a patient-physician relationship included as part of evidence-based clinical practice guidelines on telemedicine developed by major medical specialty societies. Exceptions to the foregoing include on-call, cross-coverage situations, emergency medical treatment, and other exceptions that become recognized as meeting or improving the standard of care. If a medical home does not exist, telemedicine providers should facilitate the identification of medical homes and treating physicians where in-person services can be delivered in coordination with the telemedicine services.

Physicians and other health practitioners delivering telemedicine services must abide by licensure and medical practice laws and requirements in the state in which the patient receives services.

Physicians and other practitioners delivering telemedicine services must be licensed in the state where the patient receives services or be providing these services as otherwise authorized by that state’s medical board.

Patients seeking care delivered via telemedicine must have a choice of provider, as required for all medical services.

The delivery of telemedicine services must be consistent with state scope-of-practice laws.

Patients receiving telemedicine services must have access to the licensure and board-certification qualifications of the practitioners providing the care in advance of their visit.

The standards and scope of telemedicine services should be consistent with related in-person services.

Delivery of telemedicine services must follow evidence-based practice guidelines, to the degree they are available, to ensure patient safety, quality of care, and positive health outcomes.

Telemedicine services must be delivered in a transparent manner, to include but not be limited to, the identification of the patient and physician in advance of service delivery, as well as patient cost-sharing responsibilities and any limitations in medications that can be prescribed via telemedicine.

The patient’s medical history must be collected as part of the provision of telemedicine service.

Provision of telemedicine services must be properly documented and should include providing a visit summary to the patient.

The provision of telemedicine services must include care coordination with the patient’s medical home and/or existing treating physicians, which includes, at minimum, identifying the patient’s existing medical home and treating physician(s) and providing to the latter a copy of the medical record.

Physicians, health professionals, and entities that deliver telemedicine services must establish protocols for emergency referrals.