Update on telemedicine rules

Posted On: 11/27/2013

At its Nov. 7 meeting, the State Board of Medical Licensure and Supervision tabled two of three proposed telemedicine rules of interest to providers until Jan. 16. The board adopted the rule OAC 435: 10-7-12, which sets out that a face-to-face meeting between physician and patient is not required under certain circumstances when establishing a physician/patient relationship.

435:10-7-12. Establishing a physician/patient relationship; exceptions [NEW]
A physician/patient relationship is established when a physician agrees by direct or indirect contact with a patient to diagnose or treat any condition, illness or disability presented by a patient to that physician, whether or not such a presenting complaint is considered a disease by the general medical community.

The physician/patient relationship shall include a medically appropriate, timely-scheduled, face-to-face encounter with the patient, subject to any supervisory responsibilities established elsewhere in these rules except the following providers are not subject to the face-to-face encounter:
 
(1) Providers covering the practice of another provider may approve refills of previously ordered medications if they have access to the medical file of the patient.
(2) Hospice medical directors may initiate prescriptions based on requests from licensed health care providers and on information from hospice records.
(3) Providers ordering appropriate medications for persons with laboratory-proven, sexually transmitted diseases and persons who have been in contact with certain infectious diseases.
(4) Telemedicine physicians who meet the criteria set out in OAC 435:10-7-13 of this Subchapter.
(5) Licensed health care providers providing medical immunizations, which may be implemented by means of standing order(s) and/or policies.  

New definitions have been proposed in 435:10-1-4 and are tabled until Jan. 16:

435:10-1-4 Definitions: “Telemedicine” means the practice of health care delivery, diagnosis, consultation, treatment, including but not limited to, the treatment and prevention of conditions appropriate to treatment by telemedicine management, transfer of medical data, or exchange of medical education information by means of audio, video, or data communications. Telemedicine is not a consultation provided by telephone or facsimile machine (Oklahoma Statutes, Title 36, Sec. 6802). This definition excludes phone or Internet contact or prescribing and other forms of communication such as Skype that might occur between parties but that do not meet the equipment requirements as specified in OAC 435:10-7-13. Telemedicine physicians that meet the requirements of OAC 435:10-7-13 do not require a face-to-face encounter. Telemedicine does not include treatment of chronic pain or robotic surgery.

To view the rules in their entirety, click here. 

What you need to know: OHA will continue to monitor and participate as the revisions to the OMB rules will be published no later than the beginning of 2014 to allow time for public comment by Jan. 10. The OMB executive director has indicated there may be a rule addressing telemedicine in facilities and a separate rule for consumer driven telemedicine.

In the next issue of Hotline, we will provide information on current issues in telemedicine. For more information, contact Sandra Harrison at [email protected] or Lynne White at [email protected]. (Sandra Harrison)