Guest: New telehealth law includes important patient protections

Alabama physicians will have to brush up on their “webside manner” now that a new law is on the books to improve the delivery of telehealth to patients across the state.

This new law establishes not only the needed governing framework to allow telehealth technology to grow in our state, but it also includes important protections to ensure quality patient care.

The COVID pandemic accelerated the explosive growth of telehealth. For example, early during the pandemic, doctors at UAB reported having 1,400 telehealth appointments with patients in just one day – a 350-fold increase in their telehealth appointments prior to the onset of the pandemic. This incredible surge was driven out of necessity for many of Alabama’s most vulnerable citizens, who had to turn to telehealth as a safe alternative to sitting in waiting rooms with sick patients. Telehealth provided a way for many to receive care they otherwise wouldn’t have received.

While most physicians and patients still prefer in-person visits, there’s no doubt telehealth is being embraced more widely than ever before and will become a more commonly used means to deliver health care in the future.

This is exactly why it was the right time to push for passage of the state’s new telehealth law. Before Gov. Ivey signed it into law on April 12, Alabama had no laws or guidelines on the books to govern the practice of telehealth. Physicians with the Medical Association worked with insurers, hospitals, mental health advocates and key legislators from both parties like Sens. Dan Roberts and Bobby Singleton, and Reps. Paul Lee and Anthony Daniels, to change that.

In addition to establishing the needed framework that allows telehealth to be delivered securely and efficiently in the state, this new law includes important protections for patients. Among its most important provisions are those that:

• Ensure quality by requiring physicians to meet the same standards for telehealth visits as for in-person visits.
• Prevent fraud and abuse by prohibiting telemarketing-style “cold calls.”
• Provide that telehealth can be provided only when the patient initiates medical care or upon a referral from another physician.
• Put safeguards in place so physicians cannot prescribe controlled substances to a patient without a recent in-person visit.

As a physician, I believe telemedicine is an important tool that can augment and expand traditional in-person care. However, nothing can or ever should completely replace face-to-face visits between doctors and patients. That’s why physicians worked to include a requirement that if there is no resolution to a patient’s medical problem after four telehealth visits with the same physician, the patient needs to come in for an in-person visit. That patient can still utilize telehealth for the care of other medical problems, but if the same condition hasn’t been resolved after four telehealth visits, it’s best to be seen in-person by a doctor.

This is a common sense approach that provides patients the flexibility to use telehealth when they want while also ensuring there are opportunities for face-to-face contact with their physicians when medical problems persist.

Alabama was able to catch up quickly on putting safeguards into place for telehealth. But for telehealth to work to its fullest potential, we need to make sure Alabama stays on track to expand broadband services. The two-way, interactive video technology that makes telehealth connections possible works best with high-speed internet, or broadband. Lack of broadband can be an insurmountable barrier to some patients wanting to benefit from telehealth visits. Fortunately, Alabama is making strides on broadband and is currently deploying $276 million through grant programs to help expand access to high-speed internet service to unserved areas of our state.

By expanding broadband access to every community, Alabama will be able to harness the full potential of its new, bipartisan telehealth law and the opportunities this technology brings for improved patient care.

Dr. Boothe is the founder of Pickens County Primary Care. She serves as President of the Medical Association of the State of Alabama and on the board for the Alabama Academy of Family Physicians.