Friday, Dec 19, 2014
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Bill would help regulate telemedicine

BY PAUL CATALA
Highlands Today

Published:   |   Updated: April 18, 2014 at 09:26 AM

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SEBRING - At Florida Hospital Heartland Medical Center, there are cameras, scopes, software and mobile computers, diagnostic imaging devices, electronic stethoscopes and portable EKG machines which can literally mean the difference between life and death in the emergency room.

The telemedical devices can link via telecommunication to a doctor as near as Orlando and Tampa or as far as Boston or Seattle to an emergency room or critical care physicians in Highlands County.

Although this seemingly futuristic telemedicine - the use of telecommunication and information technologies to provide clinical health care at a distance - is already being used, a Senate bill could increase its use and establish requirements for doctors who choose to treat patients remotely.

In general, the Senate bill would help increase telemedicine use around Florida and set regulations for various health providers who want to treat patients through remote means. The accompanying House bill - which among other stipulations provides practice standards for telehealth providers and requires registration of health care professionals before they may use telehealth to deliver health care services - went to House Health & Human Services Committee for a vote March 24. That bill wouldn't require a doctor to be licensed in Florida, just that they be licensed in their home state and have Florida registration.

"It's definitely something we need. It keeps everyone on the same page and it's like having a doctor at the bedside. It's what we need because of the shortage of doctors and specialists in rural areas," said Tina Milligan, a registered nurse and charge nurse at Florida Hospital, which has used telemedicine for about three years.

Rep. Cary Pigman, R-Sebring, an emergency room physician who practices in Sebring, Lake Placid and Wauchula, and supports the bill, is adamant the bill passes on both floors. As vice-chairman of the Select Committee on Health Care Workforce Innovation, he said the committee has been "looking at a lot of issues," but the bipartisan bill on telemedicine is at the forefront for him personally because it would help with access to care and increase provider efficiency.

Pigman said although telemedicine is already being practiced, it currently doesn't allow hospitals to collect revenue with it. The legislation would allow hospitals to bill for its use and doctors can collect fees for services. The Senate bill would require Medicaid to reimburse for telemedicine services and doctors would arrange payment rates with insurers. The House bill doesn't include payment stipulations.

"I think it entices access to good, quality care whether you are in rural Highlands County or in an inner-city like downtown Jacksonville," he said."I can't emphasize how important this is. It's all about access to care; it's using technology to the fullest and it's the right thing to do."

The Senate bill would also allow a doctor that's in-network in another state to be allowed to treat a Florida patient. The bill recently passed a Senate committee, but has two more stops before it's heard on the floor.

The issue is a priority for the American Telemedicine Association in Washington, D.C. In February 2013, the non-profit organization established in 1993 to promote the use of telemedicine reported 104 counties across the United States - including Highlands - lost telehealth benefits because of updated federal urban-rural categorizations which effectively revoked the option for Medicare recipients to receive healthcare services via video-conferencing. Those losses are still in effect. He said mostly counties on the fringes of metropolitan areas, like Highlands, are the ones that ended up losing telehealth coverage.

"A lot of states have been doing teleconferencing for 10 to 15 years. There's a lot Florida can learn from what other states have done. Florida may even leap-frog states with limited networks due to its aging population. There's a lot of opportunity for Florida to continue to benefit from telemedicine," said Gary Capistrant, senior director of public policy for the American Telemedicine Association.

Although the regulatory bill is backed by medical professionals such as nurse practitioners, physician assistants nurses and pharmacists, there are senate members wary of its benefit and that it could compromise patient care and doctors using telemedicine in Florida should also be licensed here.

"It may be the wave of the future, but I still think we need to concentrate on the patients and the bottom line is these (out of state) doctors are not licensed in Florida so they don't have the same accountability," said Sen. Dorothy Hukill, R-Port Organge, who voted against the bill.

The Associated Press contributed to this story.

pcatala@highlandstoday.com

(863) 386-5855

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