Legal Limits of Telemedicine

Telemedicine is the use of electronic communication technology to provide healthcare services to patients, and it is a growing part of the medical landscape. Theoretically, medical aesthetic practices could stand to benefit a great deal from using telemedicine. However, the laws that govern telemedicine are still evolving, so medical spa owners and operators should familiarize themselves with the legal issues surrounding the practice before they decide to give it a try.

Conceivably, telemedicine could alter the way that initial examinations are conducted in medical aesthetic facilities. Most states require a licensed healthcare professional—a physician, a physician’s assistant, or a nurse practitioner—to conduct a face-to-face initial exam prior to the administration of medical services. As a result, compliant medical aesthetic practices need to have at least one licensed professional on site at all times. But what if you could simply have a healthcare professional on call instead of in the office all the time? That’s the prospective advantage of telemedicine. Ideally, a healthcare professional could conduct examinations over Skype or FaceTime, and the practice would not have to pay a premium to have a licensed professional on site all day, every day.

But this does raise concerns. Can a healthcare professional conducting an examination over Skype or FaceTime detect all skin conditions or abnormalities that could complicate medical aesthetic procedures? Moreover, does such an exam sufficiently establish the doctor/patient relationship? These are just some of the questions that lawmakers across the country are currently evaluating, as legislation governing telemedicine is still evolving and open to interpretation. There is no consensus from state to state or even lawyer to lawyer regarding the practice. Entire conferences are dedicated solely to telemedicine, which should give you an idea of the controversy surrounding it.

Many states have telemedicine laws on the books, and, in general, they do tend to allow it. However, it is typically allowed in the context of continuing care and consultations with specialists in other cities, states, and even countries rather than for initial exams. If a patient is already under the care of a doctor, telemedicine is much more widely accepted than if a healthcare professional has never met the patient in person. That’s where things get sticky. In Illinois, for example, there is no legislation governing this practice, but the state medical board does not look favorably upon it. In Texas, state legislators have passed a law that sets very specific requirements for conducting off-site consultations. It’s permitted, as long as the healthcare professional performing the off-site consult is in a specific location and working under particular conditions.

With imaging technology, such as Visia, improving rapidly and HD video becoming even sharper and more lifelike, using telemedicine to conduct exams may very well be the future of the industry. However, even if the technology is viable, it will likely take quite some time for lawmakers to evaluate (or re-evaluate) telemedicine’s merits, so it is imperative that you consult a healthcare attorney who is familiar with your state’s laws regarding telemedicine. If it is not allowed and you’re caught, you could be subject to fines and/or licensure penalties.