Legal and Regulatory Barriers to Telemedicine in the United States

Technology in Health Care

“…[78][79][80][81] States can enact additional regulations using the federal laws as their foundation to have greater oversight and enforcement of their licensee.…”

“…80,89,121,162,171,[177][178][179] These include r developing interstate licensure agreements and compacts, r providing universal standards of care where there is a lack of universal standards, r having telecommunications networks being HIPAA compliant, r accessing, securing, storing, and retrieving of protected health information and health data, r abiding by state nursing regulations license to practice, r increasing the liability to multiple parties, and r obtaining patient's consent.…”

“…Although HIPAA allows for the sharing of protected health information to provide treatment, Sao et al 80 report that there is considerable confusion as to "whether today's understanding of the duty of confidentiality and informed consent extends to telemedical services." (p658) Currently, there are 24 states that are considered compact states that allow telenursing to cross between state boundaries using only 1 nursing license.…”

“…The remainder of the states require a nurse be licensed in each state the nurse provides any service as a nurse; especially when he or she provides medical information and medical recommendations. 80,110,182 In order for telematics to be most effective and efficient, communication between multiple agencies must be established prior to the implementation of any patient care. Nurses must check with their state licensing board and state regulations, when a patient's care is provided across any state line to ensure that they are adequately licensed and have the appropriate liability insurance.…”

“…80,182 The future of telehealth services will only increase as technology and medicine interact with one another, supplying even more data and information for the forensic investigator to understand and consider during an investigation. It may include not only the nurses and physicians from the health care facility but may also include the telehealth nurses, physicians, and the supplier of the tele-equipment.…”