State Medical Board Group Offers Guidelines for Appropriate Telehealth Use

To set guidelines for optimal telehealth use, the Federation of State Medical Boards (FSMB) provided updated guidelines for how providers can maintain appropriate telehealth use, including recognizing ethical codes, protecting patients confidentiality, and prioritizing welfare patients.

During the COVID-19 pandemic, telehealth has become more widely used, with a 2,000 percent increase in the number of virtual visits, according to FSMB. Despite the benefits it provides, telehealth has resulted in patient discrimination, exposing care gaps and various populations that do not have high levels of access.

To counter the disparities brought forward through telehealth, the FSMB updated its guidance on the appropriate use of telemedicine technologies, initially released in 2014. The guidance is intended to be a resource for providers, allowing them to make health equity-based decisions when treating patients through telemedicine.

The first section of the guidelines states that providers should consistently ensure they provide for welfare patients first, ensure appropriate standards, consider ethical codes, aid non-physician clinicians, and maintain confidentiality.

The second section states that all physicians must be appropriately licensed to engage in all screenings, trials, and procedures. Outside of exceptions pertaining to the ability to engage with patients out of the state they practice in, appropriate authorization for physicians is necessary.

The third section discusses standards of care, and it mentions that telehealth providers should practice the same professionalism as when they are taking part in an in-person encounter. If physicians fail to do this, the consequences could involve discipline by a medical board.

The final branch of the guidelines discusses equity of healthcare access and how education, broadband internet, and payment coverage must be up to date before patient encounters occur.

The American Medical Association (AMA) endorsed these guidelines. In a letter sent to the reference committee chair, AMA CEO James L. Madara, MD, said the guidelines proposed by the FSMB aligned with the policies of the AMA.

“The AMA applauds FSMB for its leadership in tackling these tough issues and believes the updated Telemedicine Policy strikes an appropriate balance between supporting advancement of high-quality telemedicine and protecting the standard of care, safety, and privacy of patients,” the letter states.

The guidance is yet to be adopted by the FSMB House of Delegates.

Like those released by the FSMB, previous telehealth guidelines have sought to improve equity, eliminate disparities, and ensure access for all.

For example, in November 2020, the AMA discussed new telehealth guidelines that arose following a five-day virtual meeting. The guidelines included making efforts to advance the adoption of telehealth, advocating that the government continues to adopt uniform laws, continuing to ensure access for all, and maintaining efforts to eliminate health disparities.

Further, new policies have been proposed or enacted at the state level during the pandemic to further the use of telehealth.

In Alabama, the state senate passed a bill that creates laws regulating telehealth delivery, including allowing patients to receive care virtually even if they have not met the provider in person. Kentucky Gov. Andy Beshear signed into law legislation that bars professional licensure boards from prohibiting healthcare providers credentialed in Kentucky to deliver telehealth to Kentuckians who are temporarily located outside of the state.