In a new report, the Information Technology & Innovation Foundation (ITIF) has issued a call for congressional action to spur telehealth. The report specifically calls on legislators to pass the Telehealth Modernization Act of 2013 (HR 3750), introduced in December 2013 by U.S. Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio).
That bill would create a federal definition of telehealth – "to include healthcare delivered by real-time video, secure chat, secure e-mail or telephone" – and provide guidelines by which each state could regulate the technology.
The ITIF then suggested an even stronger approach.
"While this legislation is an important step, its success will depend upon states voluntarily adopting the standard," the report states. "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."
The report cites a precedent for Congressional action in The Fairness to Contact Lens Consumers Act of 2003, which directed the Federal Trade Commission to set national rules requiring optometrists to provide patients with contact lens prescriptions. This came about, the report said, because professional boards and state legislators had caved to optometrists and passed legislation limiting the online sale of contact lenses.
The study indicates support for telehealth has been lagging because states are reluctant to give up their own regulatory authority "even when their regulations favor producers over consumers and limit nationwide innovation." It calls on states and the federal government to "work quickly to remove regulatory barriers that limit the development and adoption of provider-to-patient telehealth capabilities."
And that would start, the report says, with passage of HR 3750.
Among other things, HR 3750 would, if passed, require providers using telehealth to document the evaluation and treatment of patients and create a medical record of each visit, maintain access to the medical history of the patient, provide no assurances to the patient regarding the visit's outcome, and offer a diagnosis based on that interaction with the patient.
The bill would allow providers to issue prescriptions based on telehealth visits but would prohibit the prescription of controlled substances based solely on that telehealth interaction.
While advocating for passage of HR 3750, the ITIF also calls on Congress to:
• Establish one national license for telehealth providers (included in this recommendation is support for HR 3077, the TELE-MED Act, which would enable Medicare providers licensed in one state to provide services to Medicare benificiaries in another state);
• Create technology- and location-neutral insurance payment policies;
• Promote interoperability among state prescription drug monitoring programs; and
• Fund research to improve the quality and lower the cost of telehealth.
"Telehealth services promote substantial benefits for patients, physicians and payers," the report concluded. "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."
"Unlocking the Potential of Physician-to-Patient Telehealth Services" was prepared for the ITIF by Daniel Castro, Ben Miller and Adams Nager. Castro and Miller are analysts and Nager is a research assistant for the ITIF, a nonpartisan non-profit established in 2006.