In early 2019, the Georgia Senate passed two bills addressing telehealth and telemedicine. Both bills address comprehensive healthcare reform in order to reduce costs, increase access, and enhance quality care for Georgia residents. Since 2006, the state of Georgia has addressed telehealth parity law, and continued to address the need and coordination of telehealth care. The most recent bills (Senate Bill 115 and Senate Bill 118) continue to demonstrate how Georgia legislature has updated and revised existing laws.
The Interstate Medical Licensure Compact (IMLC) allows physicians from 43 different Medical and Osteopathic boards to practice medicine across state lines. Interstate compacts exist so that governing agencies from different states or jurisdictions are able to define an agreement which allows for members of their respective regions to operate under a mutual set of regulations.
The Nursing Licensure Compact (NLC) allows nurses to have one license to practice in multiple states. An interstate compact allows multiple states to join together and uniformly address common issues and establish guidelines that cross state boundaries to maintain regularity between governing agencies.
The Psychological Interjurisdictional Compact (PSYPACT) was approved in 2015 by the Association of State and Provincial Psychology Board (ASPPB – the alliance of psychology boards in US and Canada). By definition, a compact is an interstate agreement allowing states to enact legislation and enter a contract for a specific, limited purpose or to address a particular policy issue. One of the greatest advantages to any interstate compact is establishing a solution that uniformly addresses multi-state issues.
The Florida legislature has passed Chapter 2019-137, Laws of Florida. Signed into law by the governor and effective July 1, 2019, Chapter 2019-137 clarifies the definitions for health care providers who use or plan on using telehealth services in Florida, as well as the steps needed to provide ethical, legal and competent services within the state. The full text of Chapter 2019-137 can be downloaded on the home page http://www.flhealthsource.gov/telehealth/.
It is now mandatory for practitioners who are licensed out-of-state and do NOT hold an additional Florida license to be registered with the state in order to perform telehealth services for patients located in Florida. (Licensed Florida providers are already allowed to practice telehealth with patients they would be able to see face-to-face.)
Louisiana's LPC Board of Examiners has enacted their Teletherapy Guidelines for Licensees, which requires telemental health training prior to licensees providing teletherapy. The new regulation is clear, helpful, and resonable to comply with.
In January, 2019 the International Society for Telemedicine & eHealth published an article by Nathaniel Lacktman, Esq. and Dr. Neil Nerwich entitled, “Teleconsultation Services for the Mobile Workforce- Considerations and Guidelines for the Provision of Global Services in Compliance with Regulations and Best Practice Clinical Standards of Care.” The International Society for Telemedicine & EHealth (ISfTeH), founded in 2011, is a “nongovernmental and not-for-profit society that services primarily as the umbrella association for national Telemedicine and eHealth organizations,” advising on international standards and best practices for telemedicine.
As of December 2018, the Federal Communication Commission (FCC) has adopted an official ruling that text messages will be considered an informational service (such as emails) versus a telecommunication service (such as telephone calls). Click here for the ruling. This distinction is highly relevant, as communications classified as “telecommunication services” must be transmitted by cellular carriers and are not permitted to be blocked or altered whereas informational services can be.
As text messaging has grown in popularity over the last decade, texts have carried an ambiguous status; this ambiguity has allowed cellular carriers to make independent decisions regarding transmission, with many carriers defaulting to handle texts as informational services. For the December ruling, the FCC took into consideration that cellular providers have already been filtering text messages (in an effort to minimize spam) and that allowing all texts to go through could burden consumers.
In Opinion 19-02, the Office of Inspector General declares its support o allowing drug manufacturers to temporary loan smartphones to low-income patients who are prescribed antipsychotic digital medications. A sensor is embedded in the medication, and once taken, transmits a signal to a patch worn by the patient. The patch records ingestion of medication, rest and activity levels, and uploads the data to a smartphone app via Bluetooth. The patient has the ability to add more detailed information (moods, sleep quality) to the app, and then the app syncs with secure, cloud-based data banks.