Telemedicine In The USA - The Drawbacks

While telemedicine offers many exciting new possibilities for improvingUS health care, there is now no case law to clarify the role of telephysicians and their potential liability, according to Lori Bartholomew of the Physician Insurers Association of America. A new PIAA study, Telemedicine: An Overview of Applications and Barriers, says the degree of accountability for practitioners and jurisdiction issues are currently questions without answers.

Several federal agencies are funding research and demonstration projects to study telemedicine's use. In 1994, at least 13 grant programs totaling $85 million were approved, while in early 1995, state and federally funded clinical telemedicine programs were underway in at least 40 states. However, the PIAA notes, there are barriers, some of which result from unresolved issues due to the technology's rapid advancement, and its increased application following positive studies. These barriers include (but are not limited to): state licensure issues; availability and affordability of technology and its proper use; use of computerized medical records and confidentiality concerns therein; reimbursement; and malpractice.

Licensure Is Major Problem In the USA, physicians must be licensed in the state where they practise, but the Federation of State Medical Boards is investigating options to allow telemedicine consultation across state lines. In contrast, the American Medical Association House of Delegates adopted a policy last year calling for physicians practicing telemedicine to be fully licensed in every state where their patients are located.