The doctor is in your phone.
No, not waiting on the line, but eyeballing you through your smartphone’s camera and preparing to diagnose your laceration, cough, wheeze or bruise.
You’ve not experienced that, you say? Just wait. It’s becoming more and more likely that you will. Just don’t expect to order medical marijuana over your phone anytime soon.
While telehealth services are already available from numerous health insurers, private providers and hospital systems, supporters of bills in the Florida Legislature hope that enactment of a bill legitimizing and regulating health services through video conferencing will encourage more long-distance, health-care sessions between providers and patients.
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“Telehealth is the future of medicine, and it’s time Florida fully embraces it,” said Sen. Aaron Bean, a Duval County Republican and sponsor of a Senate telehealth bill filed shortly after a state Telehealth Advisory Council released a report in October urging Florida to enact a regulatory framework for telehealth.
The report describes telehealth as video conferencing between provider and patient, storage and forwarding of clinical data to offsite locations for evaluations by practitioners, and remote monitoring of patient conditions via sensors and monitoring devices that can be worn or implanted.
Telehealth bills have been batted around the state Legislature for years, while major hospitals and insurance companies introduced programs to their own customers. Legislators in 2016 agreed to create the advisory council and wait for its recommendations before taking another stab at a law.
Sunrise based MDLive offers treatment of minor medical problems, skin issues and behavioral health directly to consumers for flat fees ranging from $59 to $99, according to its website.
Weston-based Cleveland Clinic Florida launched Express Care Online for unscheduled visits via computer, tablet or phone in 2015, then last summer allowed patients recovering from surgery to undergo their two and six week follow up visits remotely.
“This is a huge convenience and evidence of the Amazon effect sweeping the health-care industry, including here in South Florida,” Cleveland Clinic Florida spokeswoman Arlene Allen Mitchell said via email Tuesday.
Florida Blue spokesman Doug Bartel said use of his company’s telehealth products “remains relatively low across the state” but added that “consumers using it are doing so appropriately and are enjoying this benefit.”
And children in Florida’s rural areas, particularly in the Panhandle, have access through telehealth to pediatric specialty care that would otherwise require several hours of travel, Marti Coley of Nemours Children’s Health System told senators before the Jan. 16 vote of the Senate’s Banking and Insurance Committee.
Bean’s bill earned unanimous support from the Senate’s Banking and Insurance Committee and Health Policy Committee but still faces two more committees before it can come to the full Senate for a vote. A House bill with similar language has not yet been heard by a committee.
Bean’s bill adopts the advisory committee’s recommendation to require state licensing of telehealth practitioners but stops short of spelling out how out of state nurses and physicians available through national telehealth services could provide services legally if not specifically licensed to provide care in Florida.
The advisory council recommended the Legislature enact laws authorizing multistate health care practitioner licensure compacts if eligibility requirements are at least as stringent as Florida’s current requirements. Those recommendations were not included in Bean’s bill.
As written, the bill would authorize any licensed health care provider to provide via telehealth whatever services they are licensed to provide in person.
If enacted, telehealth providers would not have to research a patient’s medical history or examine the patient in person to diagnose and treat the patient. Licensed providers would be authorized to prescribe controlled substances via telehealth except to treat “chronic nonmalignant pain.”
The bill also forbids use of telehealth to issue a physician certification of medical marijuana under the law enacted by voters in 2016.
A Senate analysis states that expanding telehealth availability would help provide health services to 647 federally designated Health Professional Shortage Areas, primarily in Florida’s rural areas, and overcome a deficit of 2,936 practitioners.
Also, Bean’s bill did not adopt the council’s recommendation to require health insurance plans to cover services delivered via telehealth if those same services are covered when provided in person. The bill also did not adopt the council’s recommendation to require insurance plans to reimburse providers for telehealth services at equivalent rates.
A September report by the watchdog group Florida TaxWatch said two insurance industry representatives on the advisory committee did not support the call for mandatory coverage and reimbursement parity. Previous efforts to enact telehealth authorization bills have failed amid opposition to proposed insurance coverage requirements.
Florida Blue spokesman Bartel said the company believes “the consumer marketplace, not the Legislature, should drive pricing in telehealth as well as with whom we contract for this offering.” In a phone interview after Tuesday’s vote in the Senate Health Policy Committee, Bean said the Senate bill could not pass with coverage and reimbursement mandates.
“I think it would be the wrong approach to force it on our health community,” he said. “Once we have standards and put it in the statute, I think you’ll see the health professions embrace it, teach it, and incorporate it into their continuing education programs.”
Bean predicted the bill would pick up steam in the House, after he gives it “a little nudge.”
“We’re optimistic,” he said.
Date: Jan 30, 2018