On June 11, 2014, the American Medical Association (“AMA”) approved a list of guiding principles regarding the practice of telemedicine.  The AMA’s adoption of the telemedicine guiding principles follows the trend of position statements, guidelines, and other policy statements addressing the practice of telemedicine already adopted by other medical specialty societies and state medical associations, which follows the increased use of telemedicine in the delivery of health care services.

The guiding principles approved by the AMA stem from a report developed by the AMA’s Council on Medical Service.  In its report, the Council recommends a set of principles to ensure the appropriate coverage and payment for telemedicine services.  The principles are aimed at supporting future innovation in the use of telemedicine, while ensuring patient safety, quality of care and the privacy of patient information, as well as protecting the patient-physician relationship and promoting care coordination and communication.  The AMA’s announcement of its policy adoption can be found here; access to the Council’s report is included in the announcement.

The principles recommended in the Council’s report and adopted by the AMA include the following:

• A valid patient-physician relationship must be established before telemedicine services are provided.  This relationship may be established through a face-to-face examination, a consultation with another physician who has an ongoing patient-physician relationship with the patient, or meeting other standards of establishing a patient-physician relationship as developed by major medical specialties.  Exceptions to the foregoing include on-call, cross coverage, emergency medical treatment, and other exceptions that become recognized as meeting or improving the standard of care, where establishing such a relationship may not be applicable or necessary.
• Telemedicine providers must abide by state licensure laws and state medical practice laws and requirements in the state in which the patient receives services.
• Telemedicine providers must be licensed in the state where the patient receives services, or be providing these services as otherwise authorized by that state’s medical board.
• Patients seeking care delivered via telemedicine must be offered a choice of providers.  Patients must also have access to the licensure and board certification qualifications of the telemedicine providers in advance of their visit.
• The delivery of telemedicine services must be consistent with state scope of practice laws.
• The standard and scope of telemedicine services should be consistent with related in-person services.  The services must follow evidence-based practice guidelines, to the degree they are available, to ensure patient safety, quality of care, and positive health outcomes.
• The patient’s medical history must be collected as part of the telemedicine service.  The telemedicine service provided must be properly documented and should include providing a summary of the visit to the patent.
• The telemedicine services must include care coordination with the patient’s medical home and/or existing treating physicians.  At a minimum, this includes identifying the patient’s existing medical home and treating physician(s) and providing such physician(s) with a copy of the medical record.
• The delivery of telemedicine services must abide by laws addressing the privacy and security of patients’ medical information.

In addition to the above standards, the AMA also adopted recommendations offered in the Council’s report supporting additional research, pilot programs, and demonstration projects regarding telemedicine.

For more information about telemedicine services, please contact Lee Kuo.