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Commentary

Online Healthcare: States Must Be More Open-Minded

Telemedicine and online consultations from home hold great promise, if the law can get out of the way.

Consequences of getting it wrong: fines, penalties and jail time
The online care delivery model implicates many legal issues, including those above and other issues such as scope of practice, informed consent, mandated reporting, and expedited partner therapy. Clearly, there are many ways an online care model can run afoul of state laws and the consequences of doing so can be significant.

Penalties range from civil fines for each violation, up to criminal felony prosecution. Violating prohibitions against online prescribing carries the biggest exposure to the most significant penalties. Several years ago, the California Board of Medicine cited six physicians not licensed in California for illegally prescribing drugs over the internet and imposed fines in excess of $48 million.

Barriers to telemedicine: patients will always lose
The online care delivery model has the potential to make healthcare affordable and accessible to millions of Americans, particularly in rural regions where access to healthcare is even more difficult. But right now, too many states are closed-minded to this potential. Antiquated laws, confusion, and mistrust by states will hold progress back.

Healthcare professionals and providers must work state by state with legislators, medical, and nursing boards to assess which laws work with this model and which ones need to be amended to allow maximum access to quality online care. Understanding the barriers faced by the online delivery model and then addressing them is the next big step for the development of this important system. This is a complicated issue, but the stakes are high and states have to get it right.

Catherine Bitzan of Gray Plant Mooty also contributed to this essay.

Though the online exchange of medical records is central to the government's Meaningful Use program, the effort to make such transactions routine has just begun. Also in the Barriers to Health Information Exchange issue of InformationWeek Healthcare: why cloud startups favor Direct Protocol as a simpler alternative to centralized HIEs. (Free registration required.)

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