The second round of revisions to the Telemedicine rules released in 2016 (revision one was in July of 2017) occurred today in the District of Columbia. The rules from the District of Columbia Department of Health were revised after telehealth industry advocates submitted comments and amendments to the initial rules.
These changes were based in part on the above-mentioned comments, as well as Telemedicine Workgroup recommendations. The DC Board of Medicine made the changes in order to reduce barriers to care and clarify some aspects of the Telemedical Health ruling from 2016.
Several of the changes addressed the validity of doctor-patient privilege and clarified the circumstances under which this is valid. Currently, video and audio consultations will be considered treatment. The new rules also both established that a “real time” consultation would be considered treatment, as well as delineated the parameters of “real time.” Another change was replacing “face to face” with “in person” in order to define the relationship between doctor and patient.
Further, these rules established that if the patient seeking treatment is located in DC, the doctor must be licensed to practice medicine in DC.
Here are the key points for Telemedical Providers:
- Telemedicine has been redefined as care via remote technology
- The rules have flexibility, and video conferencing is not required
- A valid patient-provider relationship can be established remotely, without first requiring an in-person exam. The doctor may provide real-time treatment and exchange protected health information.
- Regulations regarding exams and patient evaluations were further defined. Specifically, the provider must establish diagnoses and identify underlying conditions or contraindications to recommended treatment options before providing treatment or prescribing medication for a patient.
- Regulations regarding informed consent, practitioner licensing, and standard of care were further clarified. Patients also must establish alternative forms of communication with the providers in urgent care cases.
- Rules regarding prescribing medications were established
- Medical record requirements were established
These rules and revisions are not exhaustive, or complete. Please be advised that more revisions may occur.