Texans Need Telemedicine

It’s no secret that even with 25 percent of all Texans uninsured, access to medical care is a tremendous problem in many areas of our state – both urban and rural.

With the potential for a dramatic increase in insured Texans as a result of the passage of federal health care reform, those access problems could become significantly worse.  Without aggressive action to increase the number of providers in Texas as well as a plan to diversify diagnosis and treatment options, our state will have few tools to adequately address patients’ needs.

I believe one of the best ways to further diversify treatment methods and achieve the goal of greater medical access is to expand use of a tool known as telemedicine.  Click here for Telemedicine 101

There are several other tools for increasing access to healthcare providers. The Texas Medical Board is already doing its part to increase provider numbers by revising current rules in order to fast-track new medical licenses and renewals for providers who work with Medicaid and Medicare patients.

Two bills passed last session also aim to remedy the provider shortage: HB 2154 and HB 4471.

But I believe the expanded use of telemedicine, particularly in rural areas and other underserved parts of our state, is a step that must be taken to ensure access to all Texans.

I’ve been following the medical board’s effort to revise telemedicine rules over the past several months, and I have sought the impressions of stakeholders in this issue, including the Texas Medical Association and a major insurer who is also a telemedicine provider. It appears to me that, overall, the board’s proposed new rules for telemedicine will be a helpful solution.

There is, however, one section of the proposed rules that concerns me.  The so-called “72-hour rule” would require that when a patient presents with new medical symptoms via telemedicine, the medical provider must request that the patient participate in a face-to-face provider visit within 72 hours if the symptoms are unresolved. In these cases, the telemedicine provider may not see the same patient again via telemedicine.

In a letter to the state medical board about the 72-hour rule, the Legislature’s Rural Caucus expressed concerns about the effect such a requirement would have on access for their rural constituents, and I share their concern.  The letter states, “Changing conditions, such as federal healthcare reform, require health care providers to adapt in ways that improve quality, efficiency and access. Telemedicine is only a part of that adaptation, and state government should encourage rather than hinder these innovations.”

Moreover, because barriers to obtaining healthcare can be many things in addition to geography (i.e., no reliable transportation, a disabling illness or condition, lack of childcare or eldercare) this requirement could impede access for underserved communities and for individuals in urban areas of our state as well. And, I believe that in many cases the 72-hour rule will unnecessarily increase healthcare costs by instituting a process that could be duplicative.

While opponents to telemedicine argue that it sacrifices quality of care for quantity of patients served, I believe that with appropriate guidelines and restrictions that will not be the case. I strongly feel that health care by any legitimate means is decidedly better than no health care at all.

I appreciate the diligence by members of the Texas Medical Board to improve access. I urge board members to reconsider the 72-hour rule or at least postpone their decision until after the 2011 Legislative Session provides an opportunity to study the issue further.

For further information on telemedicine: http://tie.telemed.org/articles/article.asp?path=telemed101&article=tmcoming_nb_tie96.xml