On June 29, 2015, the American Academy of Pediatrics (AAP) published a policy statement supporting the use of telemedicine in the practice of pediatrics as long as telemedicine technologies are used “in support of and integrated with” the patient-centered medical home (PCMH) – not in place of it.
In its first statement on telemedicine, the AAP’s Committee on Pediatric Workforce expressed concern related to the increased use of telemedicine by virtual providers who provide healthcare services to patients via smart phone, laptop or video-consultations without a previous physician-patient relationship, previous medical history, or hands-on physical examination. As noted by the committee members, such telemedicine services can undermine the basic principles of the PCMH model and thus there is a greater need for regulatory action on telemedicine from states and local governments.
In taking this position, the AAP joined a handful of other physician-led organizations in questioning the use of telemedicine for a first visit or for episodic care without the primary care provider’s participation. As we recently reported, the Texas Medical Board has issued rules that take a similar stance on telemedicine, but the Board is locked in a contentious legal battle with a virtual health care provider and it remains to be seen whether the rules will be implemented. In addition, last month, the American Medical Association (AMA) tabled its discussion on telemedicine guidelines in the midst of recommendations to more closely align the guidelines with the Texas Medical Board rules.
Telemedicine providers, particularly those using a business model that does not require an initial in-person physical examination (other than what can be accessed via telemedicine technologies), should carefully monitor the AAP’s, AMA’s, and state medical boards’ activity in this area.