SOLVED97

Re-word the following: Despite decades of research that highlights the positive impact that telehealth can have on patient outcomes and patient satisfaction, providers still face many obstacles when attempting to integrate telehealth into their practice.43 State laws and regulations that govern provider practice along with health insurance reimbursement rules for telehealth vary widely and often hinder the use of telehealth in certain practice settings. Thus, it is imperative that providers understand the regulations that impact their specific practice. In a report from the ATA43 comparing physician practice standards and licensure for telemedicine by state, barriers to telemedicine implementation were identified as 1) limiting definitions of physician-patient encounters, 2) requirements related to the presence of a telepresenter on-site during telemedicine encounters, 3) additional requirements of patient informed consent, 4) limited licensure portability/reciprocity across state lines, and 5) limitations related to internet prescribing.43 Nine states (Louisiana, Maine, Minnesota, Nevada, New Mexico, Ohio, Oregon, Tennessee, and Texas) currently require a special telehealth, conditional or special purpose license for providers to practice telemedicine across state lines.43 Washington DC, Maryland, New York, and Virginia have licensure reciprocity from bordering states, while 17 states have adopted the Federation of State Medical Boards (FSMB) Interstate Medical Licensure Compact to facilitate expedited out-of-state licensure for physicians wishing to practice telehealth across state lines. This promotes portability of licensure in inclusive states which follows the registered nurse licensure compact that has been adopted by 25 states.44,45 State regulations can require physicians practicing medicine across state lines to have a license in every state where their patients may be located. Regulations governing the practice of advanced practice nurses are often addressed by both the Board of Medicine and the Board of Nursing and vary widely from state to state.44 In some states, nurse practitioners do not practice independently but are required to have established practice agreements with supervising or collaborating physicians. Supervision of Advanced Practice Nurses by collaborating physicians can be accomplished via telehealth in some states but not all.44 As training is developed for nurse practitioners, there must be a focus on the regulations that will impact their utilization of telehealth.
SCIENCE
HEALTH SCIENCE
NURSING

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