The American Telemedicine Association (ATA) hosted a groundbreaking briefing on Capitol Hill to discuss “Physician Licensure Barriers to 21st Century Healthcare”. The briefing initiated by ATA was held to inform Congressional offices, national organizations, and other key stakeholders on the current U.S. state-based licensing systems. According to ATA and other stakeholders, the present licensing system restricts quality modern healthcare.
Opening the event, Bernard Harris Jr. M.D., MBA, President of ATA and President and CEO of Vesalius Ventures said “ATA has been leading the charge in resolving problems associated with state-by-state licensure and regulation of health professionals.” In his career as a medical doctor, Harris had to reply for several separate licenses but all with the same licensing requirements.
Jonathan Linkous, Chief Executive Officer for the American Telemedicine Association, said, “It is time to explore licensure reform nationwide to help increase consumer choice, improve safety, and cut costs for patients across America. What the licensing issue is not about is partisan politics, not about taking state rights away, and not just about telemedicine since licensing is an important issue affecting the entire health and medical community.”
As Linkous pointed out, “The patchwork of state-by-state licensing creates a mire of costly red tape and has become an untenable barrier for both providers and patients. If physicians today want to do telemedical visits with patients in another state, they have to be licensed in both their home state and also in the state where the patient is located.
Also, there is no one model for the way state medical boards approach licensure so it can be very confusing across all 50 states. Resolving this problem will improve patient choice, ensure consumer safety, cut costs, alleviate regional healthcare shortages, and remove barriers to interstate commerce.”
As moderator for the briefing, Susan Dentzer, Editor-In-Chief for Health Affairs a leading peer-reviewed journal is very concerned with the large influx of Medicaid patients anticipated in the future if health reform is in place.
Dealing with children and their heart medical problems, Craig Sable, M.D., Director, Echocardiography and Telemedicine, at Children’s National Medical treats many children remotely in the U.S. but his program also provides remote cardiac services to patients in numerous locations such in Africa.
He reports that heart defects affect 40,000 children a year with 10,000 requiring critical care. It is essential that telemedicine be used so that the doctors at the Children’s National Medical Center can work with doctors in other hospitals. As he commented, he has had problems getting licensed in several states so he could practice telemedicine, but worldwide he is able to set up similar telemedicine programs, cross boundaries, and help children without problems.
Andy Mekelburg, Vice President, Federal Relations, Verizon described the issue from the consumer’s viewpoint. Today, consumers are faced with a boom in apps available to consumers and as a result, their expectations are high in terms of reliability, ease of use, and protection of their privacy.
Verizon has spent billion on the best broadband networks with increased capacity that consumers need and want to use. As he said, “Lack of technology is not a barrier to using telemedicine since the broadband now in place has created the right technological environment so doctors have the capacity to provide telemedicine. However, the present laws and regulations that Verizon and others face are hindering their ability to provide the most effective services possible.”
As a South Dakota resident, Deanna Larson, Vice President for Quality & eCare Initiatives at Avera Health, provides services in multiple states with mostly rural areas requiring multiple state licenses. These multiple licenses are needed as Avera provides e-ICUs, e-pharmacies, and telehealth.
As she explained, “One of the biggest problems that rural areas face is not having enough specialists. There is not enough population in isolated areas to attract specialists that want to work and live in rural communities. As a result, there is the need for residents in these rural and frontier areas to use telemedicine to communicate with specialists in other areas of the country.”
She told the attendees that one of the most formidable problems to getting licensed is to find the 15 to 20 hours needed to fill out the applications as the states won’t accept each other’s forms. Also, after filling out the forms, numerous calls are needed to find out the status of the applications.
Fern Goodhart, Legislative Assistant in the Office of Senator Tom Udall (D-NM), reports that the Senator has been actively exploring issues related to a national physician licensing system to operate with state boards and has plans to issue the legislation in the spring.
Another important need is to have a database operating in real-time with all states having access to information on credentialed telemedicine practitioners. The database would contain claims histories, hospital privileges, and criminal background checks.
To meet the needs of the military, Congressman Glenn ‘GT’ Thompson (R-PA) sponsored the “Servicemembers Telemedicine and E-Health Portability Act” (H.R. 1832) or STEP Act. The passage of this legislation would enable healthcare professionals to provide care crossing state lines, according to the Congressman’s Legislative Assistant Darrell Owns.
For more information, go to www.fixlicensure.org or visit www.americantelemed.org.