While uncertainty surrounds the Affordable Care Act and its designated replacement, the American Health Care Act, lawmakers in Washington and around the country are pushing ahead with proposals to regulate and reimburse services provided via telemedicine.
Providing care using electronic means is described by the AUA Telemedicine Workgroup as "an electronic revolution" that "is changing the very essence of how physicians practice medicine." The workgroup members attest that telemedicine is an innovation comparable to the printing press in its capacity to transform culture and medicine. Governments are scrambling to catch up with these developments, imposing laws and regulations that protect patients and promote equitable payment. Telemedicine may embody unique benefits—or risks—depending on the specifics of the laws that pass.
Patients are ready. A 2011 study reported that two-thirds of urology patients are already willing to engage in telemedicine.
Physicians are ready. Research from HIMSS Analytics finds adoption of telemedicine services across all practice types surged to 71% in 2017, up from approximately 54% in 2014.
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Not surprisingly, the same research finds "perhaps the greatest hurdle currently facing the outpatient market is confusion, specifically around reimbursement and physician liability." Nearly every state has considered legislation to address these issues, but a lack of uniformity contributes to ongoing confusion.
One area where a single standard has emerged is in licensing physicians to practice in multiple jurisdictions. As of June 2017, 19 states have passed laws to join the Interstate Medical Licensure Compact, which allows physicians to obtain a license to practice medicine in more than one state through a simplified application process. Each state's medical board retains its disciplinary authority, but agrees to share information essential to licensing, creating a streamlined process. A commission overseeing the Compact began processing applications on April 6, with the first license being issued April 20. The first applicant listed Wisconsin as his primary residence and was issued a license to practice in Colorado.