BOISE -- Using technology from cell phones to video chats to expand the availability of health care is popular these days from hospitals to rural farm towns. Right now, Idaho is grappling with how to standardize care, and the process isn't without controversy.
The topic of telehealth or telemedicine has been getting a lot of attention in Idaho. A large provider of remote medicine, or telehealth, recently suspended operations in Idaho, and a doctor may lose certification for prescribing antibiotics over the phone. Idaho lawmakers have asked a council to convene for recommendations on regulations for telehealth; that group should be named next month.
A Telehealth Task Force has been meeting for the last year to talk about issues, concerns and developments in the practice. Now, some of those people will be part of the council to help advise policymakers.
Telehealth is very much an established practice in other states. We're just a little late to the party, Lynda Bennett, Telehealth Task Force Coordinator, said. In a rural frontier state, telehealth is really important because we don't have access to the health care workforce in a great big part of our state.
The Telehealth Task Force is made up of roughly 70 stakeholders who talk about issues surrounding the remote delivery of health care from education and possible credential requirements to the latest in technology available and how to make it secure.
While telehealth practices have been around and used in Idaho for years, the technology is ever-evolving so different ethical and practical questions arise frequently.
I think most people understand that if a person goes into a critical access hospital and sits in their telemedicine suite, that should be okay, Bennett said. But we have the technology that a doctor could beam into their iPad, and do it in their living room. Is there a reason that should or shouldn't be allowed? Is that considered appropriate delivery of health care?
It's an issue that has sparked discussions and even arguments in the medical community, but little consensus, she said.
Should you be able to use Skype, should you not be able to use Skype? Bennett said. There are some people that say, nope, that's not HIPPA compliant. You should not use that. Other people would say if the patient signs the waiver, there should be patient choice,
The Idaho State Board of Medicine's Executive Director Nancy Kerr says currently when a doctor applies to practice telemedicine in Idaho, like 1500 providers already do, the board gives applicants a list of current regulations.
They say it's not to dissuade providers, but there is a need to ensure quality and standard of care no matter how it's delivered. Those are the types of issues being tackled with the task force and new council, Kerr said.
In other words, when you pick up the phone, it's not 'trust me, I'm a doctor,' Kerr said. You need some background information on that individual. You need to be assured that is a physician you are talking to. That if they're using technology, they're knowledgeable about that technology. That anything you share with them is secure. You're not broadcasting this into an internet system that maybe is not a secure system.
In January, the Idaho State Board of Medicine told an out-of-state physician, Dr. Ann DeJong, to discontinue telemedicine in Idaho for violations of state code, including prescribing medication to a patient over the phone without any medical basis . DeJong referred KTVBto her attorney until she is available to talk after work hours, but the lawyer did not return KTVB's call Tuesday.
After Dr. De Jong's disciplinary measure was issued, telehealth provider Teladoc recently decided to suspend operations in Idaho. The company says it provided care to 20,000 Idahoans, and has been working in the state since 2008.
Teladoc's spokesman says the company plans to work with the new telehealth council on issues regarding remote health care. Further, he wrote that the company would return to providing service in Idaho once issues are addressed.
In February of this year, Teladoc voluntarily suspended its service in Idaho. This service suspension is the result of a difference in interpretation between Teladoc and the Idaho Board of Medicine (IBOM) regarding state regulations relating to telemedicine consultations in the state of Idaho.Teladoc seeks to work cooperatively with the IBOM to address this matter, Teladoc spokesman Mike Crouch said. Once the matter is addressed, Teladoc will continue its commitment to delivering quality, compliant services to our clients in the state of Idaho.