The University of Miami initiated telehealth services in 1973 and claims the first telehealth service in Florida, the first use of nurse practitioners in telemedicine in the nation, and the first telemedicine program in correctional facilities.
Today, the university provides teledermatology, teletrauma, humanitarian and disaster response relief, school telehealth services, and acute teleneurology or telestroke. Telehealth communications are used to monitor hospital patients and conduct training exercises, and in addition, telemedicine technologies have provided earthquake relief in Haiti.
Florida’s Medicaid program reimburses physicians for telemedicine services when there is two-way real-time interactive communication between the patient and the physician at a distant site. Medicaid reimbursement for telemedicine services is limited to behavioral health, dental services, and physician services.
However, Medicaid will not reimburse for telephone conversations, video cell phone conversations, email messages, faxes, telecommunication with the recipient at a location other than the spoke site, or for store and forward consultations that are transmitted after the recipient or physician is no longer available.
In Florida, telemedicine services are provided under the Child Protection Team (CPT) program which is part of the Children’s Medical Services Network that uses a telemedicine network to perform child assessments.
The CPT is a medically-directed multi-disciplinary program that works with local sheriff’s offices and the Department of Children and Families in cases of child abuse. The CPT patient is seen at a remote site and a registered nurse assists with the exam. A physician or Advanced Registered Nurse Practitioner is located at the hub site and directs the exam.
The Florida Senate has introduced bill PCS/SB 478 (545714) related to telehealth services. The bill establishes the standard of care for telehealth service is to be the same as the standard of care for a health professional providing in person services.
The bill defines telehealth as the use of synchronous or asynchronous telecommunications to perform services that include but are not limited to patient assessment, diagnosis, consultations, treatments, monitoring, transfer of medical data, and to provide patient and professional health related education.
The standard of care for services delivered via telehealth must be comparable to in-person healthcare services with a patient evaluation available to diagnose and treat. The telehealth provider must maintain record keeping that is comparable to in-person healthcare services.
The bill prohibits a telehealth provider from prescribing lenses, eyeglasses, contact lenses or other optical lenses based solely on the use of computer controlled devices through telehealth. Additionally, controlled substances may not be prescribed through telehealth for chronic non-malignant pain. However, this provision does not prevent specified practitioners from using telehealth to order a controlled substance for a hospital inpatient or for a hospice patient.
Go to www.flsenate.gov/session/Bill/2015/10876/analyses/2015s0876.fp.PDF for more information on the Senate bill.