by MELISSA McGINLEY
The first three installments of our telepractice series tracked state and federal telemedicine legislation to help lawmakers identify the complex issues surrounding telepractice-interstate practice (locus of practice), reimbursement, and liability, to name a few. At last count, 17 states (AK, AL, AR, AZ, CA, GA, HI, IA, IL, LA, MN, MS, NC, ND, NE, OK, TX) had passed measures on telemedicine in 1997, and more telemedicine legislation is expected in 1998.
In our final column, we'd like to leave you with some questions to ask when deciding how to regulate telepractitioners in your state.
What telepractice activities are occurring now in your state or province? In other states or provinces? Who is paying for these actitivities? What federal and military activities are taking place? Could any of their standards be adapted to a state or provincial system?
What information is available on consumer and practitioner satisfaction with telepractice?
What standards need to be enacted to protect consumers? (e.g., should there be a practitioner at either end of the transmission?)
Will telepractice jeopardize secure transmission and storage of medical information in any way?
How will issues of professional discipline be handled? In which jurisdiction will consumers initiate complaints against telepractitioners? Where the care is provided or where the practitioner is located?
How will telepractitioners be licensed? Will this model adequately protect consumers in your state or province? Will this model burden practitioners in such a way as to result ultimately in harm to consumers? Can telepractice be used, or is it being used, to provide continuing education? Does this method offer advantages to traditional continuing education?
(These questions are part of an upcoming CLEAR telepractice publication for legislators, to be available in early 1998.)