In a May 27 letter written to Ohio Senator David Burke (R-Marysville, OH), Ohio Academy of Family Physicians President Suellywn Stewart, MD, expressed the OAFP’s opposition to the telemedicine amendment added to the state budget bill (House Bill 64) in the Ohio House of Representatives.
The amendment was written to accommodate a specific telemedicine company that wishes to do business in the Ohio market. In the opinion of the State of Ohio Medical Board (SOMB), the amendment significantly expands the practice of telemedicine to the point that it does not meet the minimal standard of care established by the SOMB.
On behalf of the 4,800 family physicians, family medicine resident, and medical student members of the OAFP, I write to express our organization’s opposition to the telemedicine amendment that was added to the state budget bill (House Bill 64) by the Ohio House of Representatives.
The OAFP understands that telemedicine can be a useful tool which, when used appropriately, can provide greater access to medical care for the citizens of Ohio. However, the language added to the budget (section 4731.74) significantly expands the practice of telemedicine to the point that it does not meet the minimal standards of care established by the SOMB.
The language currently contained within the budget allows for a telephone consultation – without access to diagnostic medical equipment or a medical history – to establish a patient-doctor relationship and would allow this doctor to then prescribe non-controlled substances. In addition, the requirement for diagnostic medical equipment for remote initial evaluations has been removed.
The language, as written, seems to focus more on providing access to prescription drugs, and less on providing quality medical care. In the majority of instances, the safe and effective practice of medicine requires more diagnostic information than can be gathered in a telephone call.
The OAFP, along with other physician organizations and stakeholders, has been working with the SOMB to draft rules and interpretative guidelines that provide safeguards for the use of telemedicine. A lot of time and energy has been invested into drafting Rule 4731-11-09 which was approved during the SOMB meeting held May 13, 2015. The rule will now be vetted through the Common Sense Initiative and Joint Committee on Agency Rule Review processes.
We would prefer that the SOMB resolve this issue through its ongoing rule-making process, rather than through a statutory amendment.
Safe access to appropriate care for patients should be the end goal of actions taken by the Ohio General Assembly. Section 4731.74, in our opinion, does not meet minimal standards of care for patients and should be removed from the state budget immediately.