ATA: Telemedicine meant to supplement, not 'totally replace' in-person care

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While telemedicine can serve as a viable and convenient alternative to face-to-face primary and urgent care, particularly for rural patients, it's not meant to totally replace such care, according to draft guidelines published this month by the American Telemedicine Association.

The guidelines--meant to "establish baseline practice expectations for remote consultations" in the delivery of primary and urgent care--are one of two sets of recommendations published this month for which ATA is seeking comments. The other recommendations focus on telepathology. 

"In some models telemedicine may serve a triage function," the authors of the former guidelines say. "Additionally, in some cases, patients may prefer a virtual encounter. Accommodating patient preference when clinically appropriate may reduce barriers to seeking care, enhance patient retention and potentially enhance the professional relationship."

ATA argues that telemedicine and virtual consultations are useful for patient evaluation and management, particularly because primary and urgent care overlap "with respect to acute and chronic care issues."

The telepathology recommendations are an update to a document originally published in 1999 covering specific clinical applications, regulatory issues and quality assurance, among other issues, regardless of hardware. They define telemedicine as including two-way video, email, smartphones, wireless tools and other forms of telecommunications technology. That includes synchronous, asynchronous and hybrid combinations in communications, according to an announcement.

The Federation of State Medical Boards (FSMB), last month, adopted its model policy for states without making changes the ATA had recommended, including use of a wider definition of telemedicine; FSMB's definition excluded telephone or email.

To that end, even though the FSMB sought to ensure virtual visits meet the same standards of care as in-person visits, the ATA argued that the policy set the bar for telemedicine services higher.

Meanwhile, the Information Technology and Innovation Foundation, a District of Columbia-based think tank, published its own set of telemedicine recommendations this month, including setting a standard definition; establishing a single, federal licensure for providers; and creating technology- and location-neutral insurance policies.

Comments are due for both sets of ATA guidelines by June 12.

To learn more:
- find the telepathology guidelines(.pdf)
- read the urgent care guidelines (.pdf)
- here's the announcement

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