Page 15 Unlocking The Potential of Physician to Patient Telehealth Services The Information Technology & Innovation Foundation

Interoperability is also necessary for electronic medical devices, particularly those used for
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remote monitoring, a key telehealth service. An industry consortium, Continua Alliance,
has been formed to facilitate medical device interoperability, but currently only 40 percent
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of devices are standards compliant. As a result of the lack of standardization, a significant
amount of the data produced by medical devices is not integrated into electronic health
record systems. Developing interoperable standards for medical devices will be necessary to
ensure that telehealth providers can use data from these devices to treat patients in the
coming years.

RECOMMENDATIONS
Telehealth services promise substantial benefits for patients, physicians, and payers. While
there has been some growth in adoption, much more is needed. Policymakers at both the
federal and state level can and should do more to accelerate adoption by providing a
supportive regulatory environment, developing and promoting telehealth best practices,
and reducing potential risks. These actions include:

Adopt a Standard Definition for Telehealth
As noted earlier, states vary widely in how they define telehealth, and conflicting
definitions create an unnecessarily complex legal environment for providers, payers, and
patients. To address this issue, Congress should create a federal standard for telehealth that
states should then adopt. H.R. 3750, the Telehealth Modernization Act of 2013, would do
this by defining telehealth to include health care delivered by real-time video, secure chat,
secure email, or telephone. It also specifies conditions under which health care providers
licensed in a state should be allowed to provide telehealth services. These requirements
include having access to patient records, fully documenting the medical encounter, and
providing patients access to their professional credentials. In addition, the states adopting
this guidance would be encouraged to limit telehealth providers from prescribing
controlled substances (those listed on schedule II, III, or IV). These conditions are designed
to give state regulators and patients the confidence that telehealth providers are using this
technology appropriately.

While this legislation is an important step, its success will depend upon states voluntarily
adopting the standard. If states have not adopted the standards within a reasonable period
of time (e.g., two years), Congress may want to impose penalties on the non-adopting
states. There is a precedent for such action from optometry. Optometrists long sought to
limit competition from online sales of contact lens, and they were able to convince state
professional boards and state legislators to pass rules and laws that limited patient access to
equally safe, but more affordable, contact lens. It took an act of Congress to overcome these
obstacles. The Fairness to Contact Lens Consumers Act of 2003 required the Federal Trade
Commission to establish a set of rules that, among other things, required optometrists to
provide contact lens prescriptions to their patients upon request thereby allowing patients
to get their contact lens prescriptions filled online.

Establish a Single, National License for Telehealth Providers
Complex state licensing requirements are preventing health care providers licensed in one
state from providing telehealth services in another. States have had sufficient time to

THE INFORMATION TECHNOLOGY & INNOVATION FOUNDATION | MAY 2014 PAGE 15