Idaho, aka the Gem State, is hardly the leader in regulating telemedicine. This does not mean that you won't be able to provide telemedicine or telehealth services as an Idaho medical professional, but the legislation still needs to be shaped and polished to follow the example of some other states.
In the wake of the COVID-19 pandemic, which is causing a lot of problems nationwide, it seems that the benefits of telemedicine are becoming more evident. Many healthcare providers are beginning to realize how vital and useful telemedicine services can be, so we can expect improvements made to the Gem State laws shortly.
What is telemedicine?
Telemedicine is the provision of health and medical services to a patient by a physician or another healthcare professional from a remote site through the use of information technology, electronic communication, or synchronous interaction.
This means that the examination, diagnosis, or other activities are conducted via video call, chat, email, or text without in-person interaction between the caregiver and the patient. Although the practice may have seemed unusual at first, the truth is that telemedicine is gaining momentum because of its efficiency and cost-saving opportunities.
Telemedicine focuses on decreasing administrative and logistics costs and allows the practitioners to concentrate on the patients. They can offer additional services, and the patients can receive better care for the same amount of money.
State programs like Medicaid and Medicare began to cover the expenses for remote care for those patients who are struggling to pay for medical bills. With the latest development of the coronavirus pandemic, some aspects of telemedicine are proving to be safer, quicker, and more user-friendly.
Telemedicine vs. telehealth
The two terms are often used as synonyms, though many experts point out the difference in meaning between them. While telemedicine refers to remote medical services, telehealth seems to have a broader meaning. It can refer to non-clinical services that are related to health and well-being.
Some states separate these two practices legally, while others, Idaho included, do not make any distinction between them. Idaho officials offer no definitions of either telemedicine or telehealth. As remote healthcare services develop and progress, we can expect that the difference between telemedicine and telehealth will become clear and standardized on the national level.
Where does Idaho stand?
The Gem State may not be leading the way when it comes to telehealth laws, but there are several physicians and medical practices that do offer telemedicine services to patients all over the state.
What seems to be missing is the general regulatory act that would allow both patients and practitioners to find all the necessary information in one place. In the last couple of years, Idaho officials have not been active on this front, but the reality is calling for a swift reaction and a comprehensive update.
The biggest general concern is the lack of a private payer parity law that would regulate the reimbursement for telehealth services and make the process easier and more transparent. This by no means implies that a medical specialist can't get reimbursed for their services. Insurance companies may be willing to cover the expenses, although they are not legally obliged to do so.
The Idaho Board of Medicine (IBM) has done their part in formulating the guidelines for practitioners and recipients of telemedicine services, and so did the Idaho Medicaid branch. Thanks to them, many Idahoans benefit from using telehealth options.
Strict rules make telemedicine safe
The main concern of IBM was to ensure the safety of the patients and to keep the quality of service on the same level as in traditional medical practice. Following the guidelines and standards that already exist, the Board's idea was to copy the same rules that apply to traditional practice and apply them to telemedicine. It is the only way to prevent malpractice and maintain a high level of care.
IBM focuses on the following points:
- Establishing the doctor-patient relationship
- Securing data privacy
- Ensuring adequate evaluation and treatment of the patient
- Prescribing medication in a responsible way
These are the guidelines taken from the regulation of in-person medical care provision, which proved to be essential in keeping both doctors and patients protected.
The doctor-patient relationship
A sacred bond between a healthcare professional and a patient is at the very center of every rule of IBM. The Board mandates that all physicians providing telemedicine services should comply with the traditional standards of the doctor-patient relationship.
Making appropriate evaluations and obtaining patient history is essential in understanding the needs of the patient. It is the only way to provide proper and responsible care. Telemedicine is part of the broader range of services designed to benefit the patient. In some instances, in-person meetings remain the only way to treat the patient adequately.
Unlike some other states, the doctor and the patient don't need to meet in-person before engaging in telehealth communication in Idaho. The video conference can be the beginning of the relationship. If the physician agrees to undertake the diagnosis and treatment of the patient, and the patient agrees to the treatment through the use of telemedicine technology, their relationship is valid, according to IBM.
To stay compliant, every physician practicing telemedicine should:
- Identify the patient and their location
- Disclose the identity, location, and credentials of the provider
- Obtain necessary consent from the patient
Meeting the above is obligatory for establishing and maintaining the relationship and moving forward with the diagnosis and treatment. If it is possible, the provider should allow the patient to choose the physician.
Who can practice telemedicine in Idaho?
According to IBM, the physicians practicing telemedicine in Idaho must have proper licenses for providing medical care to patients with regards to the patient's location. Doctors residing in Idaho should have a license under the jurisdiction of the state where the client is residing. The Idaho patients must be treated by medical professionals who are allowed to practice in the Gem State regardless of their state of residence.
Every telemedicine service provider has to comply with the same laws, rules, and regulations that apply to traditional medical practice. The same goes for the necessary documents and the process of creating and obtaining them.
The following are the prerequisites for providers to practice telehealth in Idaho:
- Obtaining informed consent from the patient
- Providing the continuity of service and care
- Keeping comprehensive medical records
- Ensuring the security and privacy of data
An informed written consent is the basis for moving forward with the examination and treatment. It will keep both the doctor and the patient safe and establish mutual trust. Valid consent should include:
- Proof of identity of both the patient and doctor
- The medical professional's credentials
- The document in which the patient agrees that the doctor can determine whether the diagnosis and treatment are appropriate for a telemedicine session
- A detailed explanation of the security measures used in telemedicine technologies to ensure data privacy and avoid potential risks if the measures are not followed
- The document in which the patient agrees that their information can be forwarded to third parties and under which circumstances
Service and care continuity
Each patient should be able to receive follow-up care and the information regarding their further treatment. Doctors must be available to their patients and provide documentation through the telemedicine technology or otherwise. This means that medical records should be available to patients, including their history, prescriptions, and tests.
Telemedicine practitioners must also have emergency plans that they put in motion if telehealth services are not enough and the referral to an emergency care facility is required. The backup plan should be available in written form and include all emergency protocols.
Medical records are essential for transparency and effective treatment, and they should include all doctor-patient communication, the patient’s medical history, all diagnoses, test results, scans, etc. They should also contain any other relevant documents, such as formal consents, physician instructions, prescriptions, and other information that can help treat the current or future illnesses.
Medical records should be comprehensive and available to both doctors and patients at any point. They must be consistent with all the laws pertaining to healthcare records in traditional medical practice.
Data security and privacy
One of the main concerns in the practice of telemedicine is data security. The Idaho Board of Medicine clearly states that federal and state legal requirements regarding health information privacy apply to telehealth services as well.
Providers need to comply with medical retention standards, strict privacy policies, doctor-patient confidentiality rules, and HIPAA (Health Insurance Portability and Accountability Act). The technology that the practitioners use must guarantee safe and private communication protected by encryption and passwords.
How to make your telemedicine site safe and trustworthy
Your website is one of the key elements of your practice and should be easy to navigate. The online presentation of the healthcare provider should state the following:
- Which services are provided
- Contact details of the physician
- All medical personnel credentials and licenses
- Fees and payment methods
- Additional costs
- Instructions on how to navigate the site and tools
- Estimated response time for all communication channels available
- Any third party that can have access to the patients' information
- Patient's rights and ways to exercise them
Patients should be able to have full access to their records and documents in real-time. It is also mandatory to allow clients to provide feedback and file complaints with relevant medical boards through the website or app. The information about the website operator, the domain, location, and contact details are all obligatory on the site.
There should be no advertisements whatsoever or the promotion of any products or services that can bring incentives to healthcare professionals practicing telemedicine. Links to educational websites or any information that can benefit the patient are welcome as long as there is no financial gain for the physician.
When it comes to prescriptions, there should be no preferred pharmacies. The doctors should follow the rules that apply to issuing prescriptions in person. To ensure the safety of the patients and prevent errors, the Idaho Board of Medicine encourages the integration with e-Prescription systems.
The challenges of practicing telemedicine in Idaho
With highly specific recommendations from the Idaho Board of Medicine, practicing telemedicine can be demanding in the Gem State. Although there seems to be no shortage of competent practitioners, the challenges often have more to do with technology than with medical expertise.
Telemedicine is highly beneficial to both doctors and patients, but it can be a two-edged sword if the tools are not functional and adequate. They have to comply with all the regulations, but they also have to be reliable and user-friendly. When it comes to telehealth, choosing the right platform is what makes or breaks the business.
From the patient's perspective, feeling safe comes from both trusting the physician and trusting the communication channels that they use in the treatment process. The right telemedicine solution is vital for both sides to be able to experience the full benefits of telemedicine services.
Curogram offers secure, end-to-end encrypted solutions for telemedicine practice and allows medical professionals to focus on what they do best—treat the patients.
What to look for in a telemedicine platform?
For healthcare providers that are involved in telemedicine, it’s vital to have the right tools. If you want to start practicing telemedicine, you should make sure that your platform of choice:
- Integrates with your electronic health record (EHR)
- Allows you to communicate with patients in a HIPAA-secure way
- Supports your workflows
EHRs are a crucial part of any practice because both physicians and patients rely on them for data. System integration allows your clinic to operate smoothly when it comes to administration and time management. It will save your staff a lot of time and lead to increased client satisfaction.
Curogram is an excellent example of how these platforms should work as it integrates with any EHR, eliminating the need for double entry. By streamlining the workflow, the platform allows the practitioners to see more patients and use their time for strictly medical purposes.
Curogram EHR integrations
What patients expect from a telemedicine provider
When it comes to patients, the things they want from telemedicine providers are:
- The transparency of the telemedicine practice
- The efficiency and ease of use of the communication channels
- The security of services and data
User-friendly tools will not intimidate the patients and will make them feel at ease and secure. Texting is the most popular mode of communication overall, so using a two-way texting feature will make communication with your patients easier. Curogram's exceptional feature set is a shining example of what a communication platform should offer.
The benefits of using Curogram
Curogram integrates with any EHR
Full EHR integration allows you to save time on administration and prevents double entry. This allows for better allocation of resources.
Curogram has a two-way texting feature
Texting is the most popular form of communication in telemedicine. The two-way texting feature allows you to send appointment reminders to your patients. They can reschedule the appointments easily by replying to your auto-generated reminders.
Curogram enables internal communication and file sharing
A secure internal messaging system allows for a quick and private exchange of information among medical personnel.
Curogram mimics in-person workflows
Virtual clinics and waiting rooms within one practice enable the staff to prepare the patients before the appointment and allows physicians to initiate video conferences as soon as the patients are ready.
The biggest challenge for telemedicine practitioners in Idaho is the reimbursement policy. The Gem State lawmakers have not been diligent when it comes to telehealth legislation, so there is no parity law that would regulate the issue.
The situation should improve as more people are bound to turn to telemedicine due to the COVID-19 national emergency. Since telehealth can solve many healthcare problems America is facing today, we expect concrete actions to speed up the appropriate legislative processes.
Things look a bit better for the beneficiaries of the Idaho Medicaid program because this organization reimburses for certain telemedicine services and treatments.
The benefits of using telemedicine in Idaho
All rural environments could benefit from introducing telemedicine services immensely. Patients would have easier access to their chosen physicians, while doctors could treat more people within a tight timeframe.
When it comes to costs, telemedicine can help a lot, especially for people with low income. Idaho Medicaid (IM) covers live video telemedicine for a wide range of services, which is great news for practitioners who can get reimbursed when treating Medicaid beneficiaries.
IM does not reimburse providers for remote patient monitoring or store-and-forward services. The number of patients that receive necessary care through this state-federal partnership is on the rise because of telehealth. Idaho Medicaid allows the following services through telemedicine:
- Primary care
- Specialty services
- Psychiatric diagnostics
- Crisis intervention
- Pharmacological management
The healthcare professionals that can bill their services through Medicaid are the following:
- Physician assistants
- Clinical psychologists
- Physical therapists
- Speech therapists
- Early intervention specialists
Telemedicine solves many problems in medical practice— from speeding up the administrative processes to allowing the staff to focus on patients instead of papers. The benefits of using telemedicine are substantial. Hopefully, the scope of services practitioners can provide online will expand, enabling medical professionals to treat more people.
The advantages of telehealth are becoming apparent as traditional services are proving not to be enough to cope with the COVID-19 situation. Some telemedicine platforms, like our Curogram, have created innovative ways to help identify patients that need testing the most and automate the screening process. We have taken an active role in fighting the COVID-19 crisis by offering software solutions to medical practices that decide to set up coronavirus testing sites. Curogram can mass text potential patients to invite them for testing and receive text messages from people interested in getting tested, freeing up the phone lines that are on fire since the outbreak. The system reduces staff requirements by 75%, which contributes to social distancing.
Since it saves time and money, telemedicine seems to be the future of medical care. Combining AI and robotics with telemedicine solutions will take healthcare to a new level, and we may soon start experiencing patient care in an entirely different way.
Telemedicine by State
Telemedicine by State in the US