The Arkansas State Medical Board, following the release of its
draft telemedicine proposal last November,
recently proposed to amend its regulations to allow for a
physician–patient relationship to be established via
telemedicine. Specifically, on April 27, 2016, the medical board
proposed to revise its Regulation 2 to allow for a proper
physician–patient relationship to be established by a
"face to face examination using real time audio and visual
telemedicine technology that provides information at least equal to
such information as would have been obtained by an in-person
examination." In addition, the board proposed a new Regulation 38, which would create standards
for telemedicine practice in the state. Specific requirements
include, among other things, that: (i) telemedicine services are
held to the same standard of care as in-person services; (ii) the
physician agrees to provide or arrange for follow-up care if
indicated; (iii) the physician refrains from issuing a prescription
for a controlled substance unless certain additional requirements
are met; (iv) the physician must make available to the patient the
patient's medical record documenting the encounter upon
request; (v) in advance of the encounter, the patient must have
access to information regarding the identity of the physician,
licensure and board certifications, and patient financial
responsibilities; and (vi) the physician has established protocols
for referrals for emergency services. Regulation 38 also clarifies
that while use of store-and-forward technology, such as X-rays,
MRIs, and digital images, is permitted, a patient completing a
medical history online and forwarding it to a physician does not
qualify as store-and-forward technology.
Under the current statute, an in-person examination is generally
required for a valid patient–physician relationship; as such,
these actions by the Medical Board could significantly expand the
current options for compliant telemedicine services within
Arkansas. The Medical Board conducted a public hearing involving
the proposed amendments on June 9, 2016, at 8:30 a.m.
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