- - Wednesday, August 22, 2012


Consumers are using smartphones, tablets and laptops for nearly every aspect of their lives. Access to information and online services is an expected norm, regardless of time or location. Whether it’s online banking, checking the status of a flight or getting turn-by-turn directions, consumers demand a seamless and instantaneous process for information and online services.

Is there a seamless process for consumers when it comes to access to health care? Not yet. The Institute of Medicine recently held a conference on telemedicine that highlighted the barriers many providers and patients face in using technology to access care from trusted providers quickly, simply and at lower costs. Conference participants specifically pointed to the archaic legal environment related to professional licensure as a substantial hurdle to expanded telemedicine.

The Washington metro area is a transient city for many people, including members of Congress. Many lawmakers live in Washington temporarily and often travel back to their home states. What happens if a member of Congress gets sick while in Washington? The likely scenario is finding a local doctor to receive treatment.

Another scenario is they pick up the phone and call their doctor back home and receive a consultation over the phone. Seems harmless and straightforward, right? Well, the current regulatory structure prohibits doctors from providing health care services in states or districts in which they are not licensed. Unless a doctor is licensed to practice medicine in both the District and the lawmaker’s home state, the physician is not allowed to provide health care services across state lines.

This system made perfect sense before the Internet age. As of this year, however, 63 percent of providers are using tablets to deliver health care services. Expanded consumer and health care provider uses of smartphones, tablets and laptops increasingly assist in the delivery of care. These technologies mean there is little reason health care services should be limited to within state borders.

Our health care system has moved from a model where the patient physically goes to the point of care, either at a doctor’s office, clinic or hospital, to a model where the care travels to the patient through an Internet connection.

The model is being constrained, however, by antiquated and obsolete laws and regulations. In fact, technology has outpaced the laws and regulations that were designed to support it. Medicare and Medicaid reimbursement for telemedicine is severely limited, and state licensure laws belong in the days of the Pony Express, not mobile broadband.

Today, high-definition video conferencing is used in health care settings all the time. Doctors and patients have the ability to connect remotely using applications and websites, which prevent patients from having to travel to the hospital or doctor’s office to get treatment. A doctor can easily determine whether a patient has an infection and prescribe antibiotics using video conferencing tools on a smartphone, tablet or PC. Reducing hospital readmissions through routine checkups via telemedicine would save hospitals and taxpayers billions of dollars each year.

These types of technological solutions mean more expensive office or hospital visits can be avoided altogether. Our professional licensure and reimbursement structures need to encourage these advances regardless of state boundaries. It is time we adjust our laws and truly put telemedicine at the forefront of 21st-century health care.

Members of Congress have a real opportunity to restructure the laws that govern telemedicine so that patients across the country can reap the benefits. After all, they already access care across state lines on a regular basis. Shouldn’t everyone?

Joel White is executive director of the Health IT Now Coalition.



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