An internet television program that explores the intersection of medicine and the law.

Legislative Challenges to Telemedicine

By Jonathan Terry, DO, ABIHM to Telemedicine


Legislative Challenges to Telemedicine

Our guest on Healthcare Matters is Jonathan Terry, DO, ABIHM. Dr. Terry is an osteopathic physician and surgeon and general psychiatrist who uses telemedicine extensively in his practice. Dr. Terry practices at the United Health Centers of San Joaquin Valley, which recently won the 2016 Health Delivery, Quality and Transformation Award from the American Telemedicine Association. In Part VI of our series, Physician Focus: Telemedicine, we ask Dr. Terry about legislative challenges to telemedicine and how regulation is influencing the use of telemedicine around the country.

This is only one of many questions we asked Dr. Terry about telemedicine. Check them all out here:

  1. Defining Telemedicine
  2. Ways the Affordable Care Act Affects Telemedicine
  3. Four Advantages of Telemedicine
  4. Informed Consent and Telemedicine
  5. Electronic Medical Records and Documentation in Telemedicine
  6. Legislative Challenges to Telemedicine
  7. Telemedicine Reimbursement Rates
  8. Physician Focus: Telemedicine


Mike Matray: One of the greatest challenges in rural communities is access to healthcare. What advantages does telemedicine offer in treating these under-served populations in the United States? Also, Texas, one of the largest states in the country, and one of the largest rural communities recently made it more difficult to practice telemedicine. They no longer allow doctor/patient relationship unless the patient and doctor meet face-to-face initially. How do you feel about that sort of regulation?

Dr. Terry: Yeah Mike, and you know maybe I’ll start with the regulation in Texas, talking about the face-to-face encounter, and specifically what they’re look at there is the presence of a physical exam that should be done at the first visit. That’s something that I know the American Telemedicine Association is looking at actively as many states do not require this. It’s interesting, because if you think about many specialties, think of the radiologists, the pathologists, the dermatologists. So many of these services are being conducted flawlessly without the use of a physical exam already. I think that this is one of the areas that’s very interesting, very innovative in the law that we’re seeing right now.

My expectation is that eventually what we’re going to see as, you know looking at 2015 with over 200 laws passed in the United States just related to telemedicine, it’s such a rapidly evolving field and so I think we’re going to see the pendulum swing a little bit between more conservative thinking and more progressive approaches, especially as we look at our nation’s needs for expanding services.

Mike Matray: You had mentioned that more than 200 laws were passed in relation to telemedicine last year. What are some of the highlights? What are the great advances, and what are the great hindrances that might have come out of 2015?

Dr. Terry: 2015 was a really neat year. I think that one of the biggest things that we’re seeing is just innovation across the field, Mike. We’re seeing companies that are putting a doctor in people’s smart phones, the ability to text message a doctor who could be anywhere. We’re seeing opportunities even on the web for companies, for patients to directly communicate with say a third party dermatology service, to upload a picture of that scary mole and get an opinion on it, or maybe you do need to go in and get a biopsy or something, which may not always be the case.

The laws lag a little bit behind. The neatest thing … I think the best highlight that we’re seeing is that the case laws tend to be overwhelmingly progressive. They tend to be expanding telehealth, looking at ways that how else can we safely use this technology? The incidences that I see of say physicians getting in trouble is when sort of … The same things that we see them getting in trouble for in person when they’re practicing unsafely or outside of their scope of practice.