Telemedicine Rules

iStock_000037757998_MediumTelemedicine is booming, expanding from the evaluation of people with movement disorders to those in far-flung locales without access to psychiatrists, and now, with apps on smartphones capable of capturing vital signs and transmitting them easily, to primary care.  Hot off the press, as Rick and I discuss on PodMed this week, the American College of Physicians has published recommendations in Annals of Internal Medicine to guide this expansion.  While there are few surprises here, my take on the situation is the more such bodies get on board and establish a position, the more rationally the thing can proceed, which we both predict it certainly will.

Things that are noteworthy in the guidelines include the primary directive that telemedicine services should be extended only to patients with whom the physician already has a relationship.  Hmmmm. Even in the primary care setting it seems to me that some people face a multitude of challenges in turning up at a physician's office, and some provision for that should be made.  Other recs include the need to develop reimbursement schedules for this service as well as credentialing and licensing across the country, as docs will likely be providing services to folks in other states.  Rick and I agree that as the electronic health record becomes more robust, expansion of telemedicine will take place alongside, so establishing a position relative to primary care is a good benchmark.  Other topics this week include a real world trial of pre-exposure prophylaxis in those at risk of HIV infection in the Lancet, a look at who's transmitting pertussis to infants in Pediatrics, and the rate of revision for sling placements to treat urinary incontinence in women in JAMA Surgery. Until next week, y'all live well.

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