Telepsychiatry Leader Responds to FSMB Telemedicine Policy and Calls on Medical Disciplines to Produce Guidelines

The telemedicine industry has been abuzz since the Federal State Medical Board’s SMART Workgroup’s April 26, 2014 release of a model policy for the appropriate use of technologies in the practice of medicine.

This model policy received mixed reviews from leaders from a variety of disciplines. While I understand concerns about potentially limiting language within the document, in general, I was pleased with the model policy and applaud the FSMB for taking action and producing a solid foundation on which states and disciplines can build. Though the policy may not be perfect, it certainly was broad enough that it encapsulated both medical and behavioral health care without being overly restrictive.

In today’s rapidly evolving health care environment, we must expect change to be constant, and expect that telemedicine policy advocates are going to constantly battle to keep regulations up to date with blossoming trends in technology and care delivery. There will inevitably be gray areas.

Given this inevitability, I applaud the FSMB’s attempts to be open-minded by developing this model policy. They did not move to a granular level that outlined specific standards for certain applications or disciplines of telemedicine, but instead produced a template that I believe sets reasonable standards from which individual states can build.

As a company that has built telemedicine programs in 19 states, each with unique regulatory environments, my team is intimately aware of the headaches and controversy that stems from state regulation and policy that was written well before the thought of telemedicine. After working with officials in multiple states to interpret and adapt language in order to appropriately increase access to needed care via telemedicine, I can assure you that a model policy from an entity like the FSMB is a major step in the right direction.

If all 50 states were to suddenly adopt the model policy as their own, the telemedicine industry would be catapulted to a whole new level of care possibilities.

In addition to appreciating the foundation the FSMB built with their model policy language, I also praise the organization for taking the time to release this sort of document and in doing so, actively acknowledge the direction that medicine is going.

Accessing providers and treatment through technology is the future of care, and while attempts to keep up with the industry may always be imperfect, they are steps forward and steps towards normalizing this modality of care.

During this “pioneer period” full of gray area and ambiguity, there is unfortunately the possibility of poorly executed telemedicine practices souring the growth of the industry in general. In this era of rapid growth for telemedicine, it is vital that care is delivered appropriately, and in order to do so, individual providers and organizations need a strong definition of what is and is not appropriate.

Thus, I call on the individual medical disciplines to create their own guidelines and definitions for the appropriate application of telemedicine to their area of specialty practice.  While this is in the works in several areas, including psychiatry, I firmly believe that it is of paramount importance that this direction be offered by the professional associations sooner rather than later.

The American Psychiatric Association needs to produce a current set of guidelines for telepsychiatry. Though there was a lot of attention on telepsychiatry at the recent APA annual meeting in New York City, there is still a great deal to be accomplished to move from education and rhetoric to action.  I challenge the American Psychiatric Association to utilize the expertise of its membership to write a series of standards that can accompany state medical regulations and create a solid guidebook of clinical expectations.

While the American Telemedicine Association has created an excellent series of discipline-specific best practice guidelines, including a recently revised version for telemental health, when it comes to the practice of medicine, the onus is on the collective professional community via their representative associations to define their own expectations and standards of care for their particular area of practice.

I challenge each discipline to follow in the FSMB’s footsteps by producing a guideline document that creates a foundation from which to build while leaving room for growth and flexibility as each discipline’s use of telemedicine evolves.

Author Geoffrey Boyce will be presenting at the American Telemedicine Association’s Annual Expo on how to appropriately develop telemedicine service models in the context of complex, nuanced state telemedicine policy. The discussion, entitled “A Provider Company’s Perspective on Multi-State Telemedicine Policy” will be Monday, May 19th at 3PM in meeting room 327. 


Geoffrey Boyce

geoffreyboyce1Geoffrey Boyce is the Executive Director of the CFG Health Network’s InSight Telepsychiatry. Since 2008, Boyce has advocated for the appropriate use and value of telepsychiatry and has developed unique telemedicine programs within areas of greatest need. Boyce is an active participant in telemedicine advocacy, education and reform initiatives, regularly interacting with state and local healthcare regulators and administrators. Boyce frequently speaks about the potential of telemedicine and the best practices for establishing new programs. Boyce holds an MBA from Terry College of Business at UGA with a focus on entrepreneurship and business planning.

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