Telemedicine has always held great promise. In my field, it could allow experts in movement disorders to actually observe a patient in a remote area where no experts were available to see what the abnormal movements look like and to interview the patient. And I’ve often had patients request therapy sessions by Skype or FaceTime (I’ve always declined such requests). State laws regulate the use of telemedicine and the communications systems, and practitioners need to know their state’s laws. They also need to be aware of the privacy and security concerns associated with various communication systems. See, for example, this somewhat frightening report by Declan McCullagh on how NSA can eavesdrop on Skype.
Mike Stinebiser writes:
Just as the September 23 enforcement deadline of the new HIPAA rules arrives,The Oklahoman reports a case of a doctor who did not take heed of state health regulations for practicing telemedicine. Dr. Thomas Trow is being disciplined for prescribing powerful meds to mental health patients over Skype video chat without ever having seen them in person. With few exceptions, most state health laws require an initial in-person visit to establish a patient-physician relationship before before a doctor can treat a patient over video conference. This includes prescribing drugs, rendering diagnoses, and performing other medical services during a virtual visit. In addition, medical board documents also show that Skype video chat, which Dr. Trow was using, is not an approved telemedicine communication system.
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