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AMA expands Health Workforce Mapper tool

The American Medical Association has updated and expanded their Health Workforce Mapper tool, which uses data-visualization to locate physician shortage areas. The tool provides information on an area's healthcare workforce, including specialists and subspecialists, searchable by state, county or zip code. The tool also shows healthcare facilities and information on transportation and geographic features, such as highways, mountains and waterways, that could affect access to care. The tool has been used to help inform policymakers on issues related to telemedicine and scope of practice as ways of addressing healthcare shortage areas.

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Great Britain examines loopholes for online pharmacies

The General Pharmaceutical Council, in conjunction with the Department of Health and Social Care and other regulators, is examining loopholes in legislation that allow some online pharmacies to operate without regulation. Online prescribing services must register with the Care Quality Commission only if they employ a listed healthcare professional, which does not include pharmacists or pharmacist prescribers. The CQC's responsibilities include regulating online primary care services, but it was set up when few internet primary care providers of internet prescribing existed.

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Pennsylvania considers telemedicine bill

A telemedicine bill has passed the Pennsylvania Senate, which would allow licensing boards to regulate telemedicine within the scope of practice and standard of care regulated by the board. Health care professionals could utilize telemedicine technologies as long as they are able to determine that they can meet the same standards of care as if the healthcare service were provided in person. The bill also allow for insurance coverage and reimbursement of telemedicine.

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British Columbia: new telepharmacy requirements

Amendments to the Pharmacy Operations and Drug Scheduling Act Bylaws and the Telepharmacy Standards of Practice came into effect in November. The amendments are based on information gathered during review and inspection of telepharmacy sites since 2014. The amendments create a new telepharmacy license type, increase the required inspections and audits of telepharmacies, and allow telepharmacy records and documents to be transferred to the central pharmacy on a yearly basis. The amendments also set out new standards of practice for direct supervision, receipt and transfer of prescriptions, prescription processing, patient counseling and document storage.

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Update: US House passes VA telehealth bill

The House Veterans Affairs Committee has passed a bill that supports the Department of Veteran's Affairs's "Anywhere to Anywhere VA Health Care" program announced in August. The bill requires the VA to report back in one year with information on telehealth's impact on healthcare and feedback from veterans. A similar bill is being considered in the Senate.

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US Department of Veteran Affairs issues proposed rule on telehealth

The Department of Veteran Affairs (VA) has issued a proposed amendment to its medical regulations to standardize the delivery of care by VA health care providers through telehealth. The proposed rule notes several statutes that confirm the intent of Congress for VA to operate a national healthcare system for beneficiaries through telehealth. However, also noted is that "the current disparities between VA healthcare practice in telehealth and state laws have effectively stopped or inhibited VA's expansion of telehealth services to certain locations." The proposed rule would allow VA to "exercise Federal preemption of state licensure, regulation and certification laws, rules, regulations or requirements to the extent such state laws conflict with the ability of VA health care providers to engage in the practice of telehealth while acting within the scope of their VA employment." The proposed rule would not expand the scope of practice for VA healthcare providers beyond laws of the provider's state of licensure, particularly related to prescription of controlled substances. VA health care providers would be required to maintain "credentials in accordance with the requirements of their healthcare specialty."

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Texas updates telemedicine laws

Several bills were signed into law recently in Texas concerning telemedicine. Patients will now be able to get prescriptions from doctors via electronic means without the requirement for an in-person meeting first. Rural hospitals will be able to receive grants to purchase remote monitoring equipment for neonatal intensive care. Physicians and other providers providing telemedicine services in schools will now be eligible for Medicaid reimbursements. Pharmacies will be able to establish remote dispensing sites using telepharmacy.

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New Jersey legislation expands telemedicine

A new law in New Jersey expands the scope of telemedicine. The law provides definitions of "telemedicine" and "telehealth." The law allows healthcare practitioners to engage in telemedicine and telehealth via "interactive real-time two-way audio in combination with asynchronous store-and-forward technology" as long as they feel that they are able to meet the same standard of care as with in-person services. State professional boards are directed to adopt rules and regulations in order to implement the law; the rules and regulations cannot require an in-person visit with the patient as a prerequisite to providing telemedicine services.

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Texas looks to approve telemedicine bill

A bill awaiting the governor's signature in Texas would redefine and expand on telemedicine concepts. The bill defines the difference between telehealth services and telemedicine medical services. The bill removes the requirement for a face-to-face encounter prior to the use of telemedicine, specifically that "an agency with regulatory authority over a health professional may not adopt rules pertaining to telemedicine medical services or telehealth services that would impose a higher standard of care than the in-person standard of care." The Texas Medical Board, Texas Board of Nursing, Texas Physician Assistant Board and Texas State Board of Pharmacy would be required to jointly develop rules that establish the determination of a valid prescription. The bill restricts the prescribing of abortion-inducing drugs via telemedicine. The bill does allow coverage parity for telemedicine, but not to include audio-only or visual-only services.

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Enhanced Nurse Licensure Compact adopted by states

Utah has become the eleventh state to join the Enhanced Nurse Licensure Compact (eNLC). As soon as 26 states enact the eNLC, or by December 31, 2018, it will come into effect. The eNLC includes updates to the current NLC to allow Registered Nurses and Licensed Practical/Vocational Nurses to practice in any NLC state with one multistate license. Under the eNLC, licensing standards are aligned in all states, including a federal and state criminal background check. The eNLC also allows for telehealth nursing services. States where the eNLC is already adopted are Arizona, Florida, Idaho, Missouri, New Hampshire, Oklahoma, South Dakota, Tennessee, Virginia and Wyoming.

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