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Sunday, Jun 17, 2018
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Telemedicine puts Florida out in front of patient care

On a Thursday night in December, in a rural Panhandle town, a 50-year-old woman looked at her husband during dinner and noticed his normally handsome face had morphed into an odd appearance, with the left lip sagging downward. She asked her husband how he felt, and the response was a mix of gibberish. They both recognized that these may be signs of a stroke and quickly headed to the nearby emergency department at a critical-access hospital staffed by a single physician during the night.

The physician assessed the patient and agreed that he is indeed likely suffering a stroke. At that point, the doctor wheeled in a computer with a camera attached to the top and made a call to a neurologist at an academic facility in Alabama. The neurologist appeared on the monitor in front of the patient. Together, the neurologist and the emergency physician examined the patient and determined the patient was eligible for a powerful drug that can result in better outcomes after a stroke.

This collaboration between two specialists would likely not be possible in a resource-limited area without the use of telemedicine, given the current shortage of physicians in the state.

The expansion and regulation of telemedicine is being considered by the Florida House and Senate. It’s a rare opportunity for legislation to benefit patients, doctors and hospitals throughout Florida while also allowing Democrats and Republicans the chance to work together on an important topic for Floridians.

The Florida Medical Association agrees that telemedicine is a tool to expand access to areas where there are too few doctors or when a second opinion is needed quickly. If there is appropriate accountability, we can increase the ability for patients, even in rural areas, to see specialists quickly.

In order to obtain this accountability, we feel that telemedicine providers should be licensed in Florida or hold a telemedicine certificate under the jurisdiction of the Florida Board of Medicine. In addition, these physicians should meet the same education standards we hold our Florida physicians to on a daily basis.

For telemedicine to work over the long term, there must be a way for providers to be reimbursed by third-party payers at appropriate levels that avoid unnecessary charges to patients from hospitals trying to seek other avenues to reimburse telemedicine providers. In other words, parity for face-to-face consults and telemedicine consults must apply in the private insurance market as well as Medicaid, since the physician expends the same amount of time, skill and expertise in both.

Look at the example from the Department of Veteran Affairs, which demonstrates that telemedicine in rural areas reduces hospital admissions and hospital stays by providing access to high-quality care more quickly. The expansion of telemedicine also has the potential to improve care coordination, reduce hospital admissions, generate savings and increase quality and access.

It would be a shame if we miss an opportunity to expand and regulate an innovative and important segment of health care that has the ability to do so much good for patients and bring so many groups together in Tallahassee. It is our hope that a strong telemedicine bill passes the House and Senate with appropriate regulations for licensing, accountability, education and reimbursement.

Jason W. Wilson is a Tampa General Hospital physician and an assistant professor at the University of South Florida. Janet Cruz of Tampa is state representative for District 62; she is the ranking Democrat on the Health Care Appropriations Subcommittee.

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