In a few short months, the Texas legislature will convene to discuss annual budgets, political financing and what just might be the future of healthcare in America — telemedicine. Here, the Texas legislature has the opportunity to clear up existing regulations and bring care to thousands of Texans who otherwise might not have been covered.
Telemedicine is the remote diagnosis and treatment of patients using technology, usually in the form of a phone call or video conference. Patients get real doctors and real prescriptions, but the service is conducted entirely virtually and run by publicly traded companies rather than traditional healthcare providers. Telehealth costs less than traditional doctor visits and is more accessible, making it a valuable tool for vulnerable patient groups.
The need for a site presenter (or telepresenter) sitting with new patients is a current telemedicine regulation that should be eliminated. The Texas Medical Board instituted the rule as a way to keep the standard of care as close to an in-person physician visit as possible. However, having a licensed professional in the room at all times is not a standard that even traditional healthcare always meets. According to Tara Kepler, telehealth attorney and A&M adjunct law professor, even the medical assistants who facilitate in-patient appointments aren’t always licensed. Kepler claims that traditional standards of care are no longer a given and that she would like to see more legal direction on what can be delegated to non-physicians.
“Before, it was you have to have a building and a doctor, that’s it,” Kepler said. “But now you have to have a technology expert, you have to have a physician and you have to have a marketing expert. The standard of a proper physician-patient relationship is changing in front of us.”
Texas has many potential patients who could benefit from telemedicine. In 2010, Texas had the highest number of uninsured people of any state at 6.2 million, and in 2000, it hosted the nation’s largest rural population with more than 3.6 million.
“When you have a psychiatrist who has patients in rural Texas that are in a poor area, they can’t afford any healthcare, and you’re willing to have a really advanced expert child psychiatrist beam in through telemedicine to treat these kids for almost nothing,” Kepler said. “It’s beautiful, and it’s something we need more of.”
Though the prospect of loosening regulations always raises concerns about the potential of companies to take advantage of vulnerable patients, site presenters offer little quality control for the massive monetary costs involved with their presence.
Texas’ debate over the best telemedicine practice is just a microcosm of what medical boards and companies are battling all over the country; we are just the first to attempt to codify the practice. A legislative decision to remove the need for a site presenter would be one small act that could expand millions’ access to healthcare without compromising existing standards.
Whatever decision comes this legislative session, the eyes of the country are upon us.
Hallas is a Plan II and health and society sophomore from Allen.