Florida laws that pertain to telemedicine are precious few. In fact, there is really only one regulation dead on target, and that requires face to face physician contact with a patient in order to write a prescription. The impact of the hormone replacement therapy (HRT) providers was pretty immediate, but the legal issues related to telemedicine are just not currently addressed in Florida law. Does providing a telemedicine consult create a physician patient relationship? What are the requirements related to the medical records arising out of the consult, and who owns the records? These issues and many more are simply not handled. And yet, if it is true that telemedicine will be an important tool in the effort to both broaden the availability of care while reducing associated costs, we can be sure that Florida law will evolve on these issues.
The Board of Medicine is set to dip its toe into the telemedicine pond as it considers a recently filed request for declaratory statement. Dr. Stephen Haire petitioned the Board to see how the only clearly applicable law (64B8-9.014, F.A.C.) affects his practice’s plans to provide telemedicine services. Here are the pertinent facts:
- Dr. Haire is an emergency physician and a member of a practice.
- His practice wants to enter into contracts with companies to provide telemedicine services for employees of the companies on a 24/7 basis.
- The services will not involve urgent medical issues.
- The only medicines they expect to prescribe are antibiotics, antihistamines and over the counter medicines, but they are not insisting on the right to prescribe anything.
The Board will address the arrangement and is also considering broader regulations regarding telemedicine at this time.
In another petition, Dr. John Cottam is seeking clarification of how the teletranscribing rule will affect his plans to expand the scope of his dermatology practice. As he explains in the petition, high resolution video and technology combine in such a way that offers a reasonable alternative to face to face physician-patient contact. Dr. Cottam asks whether the teletranscribing rule would allow him to conduct the remote exam and thereby satisfy the rule’s requirement that there be a “documented patient evaluation.”
The interesting thing about the proposed arrangements is not only how the teleprescibing rule affects them, but also how far the Board might go in addressing the many issues that arise in the context of telemedicine.