Colorado's New Telehealth Guidelines, a Model of Progress or a Step too Far?
In a recent decision, the Colorado Medical Board has declared new guidelines in the state to embrace looser regulations on patient's ease of access to telehealth services. The guidelines allow for patients to schedule a virtual appointment without a previous in person meeting with the physician, and do not require specific technology or for the patient to engage in the appointment from designated facilities. Parts of this decision are controversial, since many people believe that an in person baseline appointment should be required before access to telehealth is allowed.
The industry watch group, the Washington D.C based ERISA Industry Committee, praised the decision as “forward-looking,” since Colorado is looking for innovative ways to address the state's shortage of primary care physicians. This open-ended approach to telehealth accessibility stands in contrast to the policies of other states, which have favored tighter regulations. The case can be made that Colorado's flexible policy will benefit healthcare in the state by removing barriers to access and expanding the scope of physicians.
Colorado's new rules are all about streamlining access to telehealth. By not requiring a previous in person visit to schedule a virtual appointment, the guidelines allow patients to connect with any doctor at anytime, which may or may not be a good thing. In cases where patients live remotely this could be a great success, but in cases where patients seek inconsistent healthcare online from unaffiliated providers instead of relying on an established network could cause problems.
In the rule’s defence, they’ve included the recommendation that physicians review patients' medical history before before issuing medical attention, in an attempt to ensure that nothing is missed in a virtual visit that would have otherwise been caught in person. But this recomendation is not mandated, and many states worry that implementing the same legislation will lead to lower standards of care.
The Board's guidelines recognize the means to verify both a physician and a patient’s identity electronically now substantially exist, making the provision of an in person meeting before beginning telehealth interactions less necessary. That being said, there is still always a margin of error, and it is up to legislators to determine whether this risk of identity fraud is worth it. Either way, people are wisening up to the idea that telehealth consultations are increasingly being seen as a mundane, everyday extension of conventional healthcare, rather than an experimental oddity requiring elaborate oversights and red tape.
In general, telehealth policies that favor openness and ease of access without sacrificing standards of care will create conditions that get the most out of the technology. Colorado has taken a big step toward the future by adopting guidelines that maximize accessibility and promote a universal framework within the state with the fewest possible barriers. With 74% of U.S employers intending on offering telehealth coverage by 2016, Colorado may not have gotten it 100% right, but at least they're taking legislative steps to make telehealth to available to everyone who needs it.