We live in a highly connected society, and the notion that a medical visit needs to occur within the traditional four walls of a clinic or hospital is already becoming obsolete.
As the technology-enabled health care is proven to be as good as, or in some cases better than in-person care, state medical boards and the federal telemedicine legislation will find it less appealing to rely on regulations designed for a pre-telemedicine era.
How clinicians are licensed and monitored for quality and safety will ultimately need to change according to the future possibilities of health care.
Cross-state licensure is one of the top barriers to the expanded use of telemedicine across the country.
The cost in time, money, and resources of applying for licenses in each state in which a physician seeks to practice is a serious deterrent to expanding medical services across state lines. Ten state medical boards have created a “telemedicine license” to accommodate telemedicine professionals, and a few states have special arrangements for practice in contiguous states, but the physician will still need to apply and spend time and resources to obtain the license for each state.
Further, according to the American Telemedicine Association, D.C., Maryland, New York, and Virginia, are the only states that allow licensure reciprocity from bordering states.
At this time, iNHS is fully licensed to practice medicine (including telemedicine) in Virginia with limited telemedicine in Maryland and DC.
In the District of Columbia:
Most of the country does not require patient informed consent before a telemedicine encounter. Sixteen states and D.C. have informed consent requirements with Alabama, Indiana, Oklahoma, Texas, and Washington requiring written acknowledgement from the patient.
This requirement is sometimes stated within the state Medicaid program, and sometimes within the state administrative codes.
The following is the General Assembly of Maryland Article for Health Occupations code of adjoining state, in Maryland :
Source: Code of Maryland Admin. Regs. Sec. 10.09.49.07.
Subject to the rules, regulations, and orders of the Board,
the following individuals may practice medicine without a license:
(1) A medical student or an individual in a postgraduate medical training program that is approved by the Board, while doing the assigned duties at any office of a licensed physician, hospital, clinic, or similar facility;
(2) A physician licensed by and residing in another jurisdiction, if the physician:
(i) Is engaged in consultation with a physician licensed in the State about a particular patient and does not direct patient care; or
(ii) Meets the requirements of § 14–302.1 of this subtitle;
(3) A physician employed in the service of the federal government while performing the duties incident to that employment;
(4) A physician who resides in and is authorized to practice medicine by any state adjoining this State and whose practice extends into this State, if:
(i) The physician does not have an office or other regularly appointed place in this State to meet patients; and
(ii) The same privileges are extended to licensed physicians of this State by the adjoining state; and…..
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For seniors living at home and for non-medical or non-emergency situation, video with a doctors is better than phone chat with a nurse or in-person appointment for chronic cases where monitoring is much needed.