If telemedicine is good for EMS, it’s good for individual patients
Back in April, the Texas Medical Board (TMB) adopted some of the most stringent telemedicine regulations in the country, which would require a physician to conduct a face-to-face physical examination of a patient before that physician can treat the patient remotely, via telemedicine. Essentially, the new rules would prevent telemedicine firms from operating in Texas in their current form.
Teladoc, a telemedicine company based in Dallas, filed a lawsuit claiming the rule, if put into effect, would eviscerate their business model and unfairly restrict telemedicine firms from operating in Texas.
In May, a federal judge issued a preliminary injunction to prevent the new rules from taking effect while the lawsuit proceeds.
If TMB’s telemedicine rule is upheld in court, some observers are concerned how it will impede the expansion of telemedicine in Texas, which the Legislature supported in this past session. For example, the EMS and Emergency Responder Telemedicine Pilot Project stems from House Bill 479, which directs the Commission on State Emergency Communications, in collaboration with the Texas Tech University Health Sciences Center (TTUHSC), to assist emergency responders in certain rural West Texas counties with telemedicine technology for emergency care.
In practice, that means ambulances will be equipped with audiovisual technology on a secure Internet connection so EMS personnel can communicate with and transmit medical data to physicians at regional trauma centers when assessing patients in the field.
Counties that would benefit from the pilot project include Hale, Kimble, Lamb, Mason, Reeves, and Schleicher. Because EMS personnel, not individual patients, will be using audiovisual technology to communicate directly with physicians at trauma centers, TMB’s new telemedicine rule will not affect the pilot project.
That’s good news for the future of telemedicine in Texas. The pilot program will likely show how emerging telemedicine technologies can bolster emergency medical infrastructure in rural areas and help improve health care and save lives.
Many rural communities in Texas have EMS systems that struggle to adequately serve large, sparsely populated areas of the state. TTUHSC conducted a survey in 2013 of emergency medical services in West Texas rural counties and found major EMS coverage problems: long travel distances to receive care, a shortage of health care professionals, and the economic hardships of rural hospitals and EMS providers.
The West Texas EMS services that participated in the survey reported that the distance from EMS sites to trauma centers can present serious challenges when treating patients in emergency situations. Given that TTUHSC spans an area of 131,459 square miles across 108 counties with a population of more than 2.8 million, it’s clear that these weaknesses in the system need to be addressed.
That’s where telemedicine and the pilot project authorized by the Legislature can help.
Under the pilot program, EMS responders will be able to consult a physician in real time to provide diagnosis and treatment advice while the patient is en route to the trauma center.
If physicians can safely give diagnostic and treatment advice to EMS responders in an emergency, they should be able to do the same for individual patients in a nonemergency.
This past spring, TMB justified their new restrictions on telemedicine in part by arguing that it wouldn’t be safe for physicians to diagnose or recommend treatment to patients without first having a face-to-face meeting. And yet the physicians with whom EMS will be communicating in this pilot program will likely have never seen or treated the patients under EMS care.
The fact is, telemedicine that directly connects individual patients to physicians is safe. It is widely practiced in many other states, and Texas should embrace it — not regulate it out of existence.
Many rural communities in Texas have EMS systems that struggle to serve them.