An evaluation was conducted by the Maryland Board of Physicians concerning new “telehealth” rules for expanding the ability to deliver care through virtual means. The rules are loosely based on those implemented in Washington D.C., with input from telehealth service advocates and the Maryland Telehealth Alliance.
These rules reflect what they deem to be a priority and seek to further build support and acceptance for increasing telehealth applications in medical care. Many skeptics about telehealth cite key concerns including the ability to adhere to the standards of care and concerns with confidentiality and security of communicated information—all key potential provider liabilities.
Telehealth makes use of tools including live audio and video to allow for medical providers to provide services to patients remotely. This allows a medical provider who is in one physical location to interact with a patient at a different physical location and includes:
- Real-time communications through audio and video
- Store-and-forward communications, which allows for data to be securely transmitted via email
- Services such as remote interpretation by radiologists
- Allow for patient monitoring to be done remotely, outside of a traditional medical setting
Telehealth is not conducted by telephone using only audio, or through basic electronic mail or fax.
Meeting Standards for Care, Confidentiality & Security
Health care provided via telehealth is consistent with the standards of that practiced in a traditional medical setting. The provider will have access to all the same data. When telehealth is conducted using real-time audio and video communication the following must be done:
- Confirm the physical location of the patient
- Verification of the patient's identity through currently accepted means
- Identify any others who are present at the provider's location
- Confirm that only those permitted to listen to the personal health information are present at the patient location
- Have a backup plan if there is a technical problem with the connection
Medications may be prescribed in the same manner as if the parties were meeting in person as long as standards and guidelines are satisfied. Patient care and prescribing decisions may not be solely based on results from online questionnaires. Generally, providers will not prescribe opioid medications via telehealth unless the patient is located within a health care facility or in the presence of a licensed medical provider.
Telehealth services require a patient's consent either orally or in writing. This consent must include privacy risks, the breach of data policy, and any steps to be completed in the event of a breach. Patients have the right to exclude anyone from being present during telehealth, a right to record the interaction, and may decline telehealth services if they wish.
Privacy & Security of Medical Records
Telehealthcare will be documented in the form of a medical record. Practitioners must implement current privacy and security standards including usage of encryption and passwords to protect data. In the event of a data breach, patients must be properly notified according to accepted practice.