Telehealth – Legal Concepts to Know and Understand

Regardless of whether your legal practice touches health care, understanding legal concepts related to telehealth will make you a more informed health care consumer.

If you are out of state and find yourself in need of a prescription, you may wonder whether your Ohio physician can write it for you. Does the physician need to conduct a video visit, or can you send the physician a message through an online portal? Is there a difference if it is a refill or a new prescription? Does it matter if the prescription is to control blood pressure or pain? The answers depend on a number of factors, namely a complex network of overlapping laws, reimbursement policies, and professional licensure rules. The bottom line is — if you know the answer for one state, you know the answer for one state.

Telehealth Terminology and Background

Before getting into the legal landscape, it is helpful to understand key terminology. Specific definitions and terms used to describe telehealth vary depending on the context. State and federal laws, reimbursement policies, professional licensure rules, and hospital policies may use different terms to refer to the same thing. Digital health is one of the broadest terms used in this space and refers to the use of information and communications technologies to manage health and promote wellness.

Digital health encompasses wearable devices that track fitness and blood pressure, mobile health (mHealth) applications and software, artificial intelligence technologies, telehealth, and telemedicine. Virtual care is also a wideranging term, but is more clinical in nature and includes all the ways that health care providers interact remotely with their patients.

Telehealth is the use of electronic information and communication technologies to support remote clinical health care, patient and professional health-related education, health administration, and public health. Telemedicine is a type of telehealth and refers specifically to the diagnosis and treatment of medical conditions remotely Though there are technical differences, these terms are often used interchangeably.

Asynchronous telehealth refers to communication between providers, patients, and caregivers stored for future reference or response. Examples include e-mail or text messages with follow-up instructions or confirmations, images for evaluation, and lab results, or vital statistics. Synchronous telehealth refers to real-time interactions between patients and providers. Examples include video calls to share progress or check on healing, audio only calls to confirm instructions, and live messaging to answer patient questions.4 The originating site is the site where the patient is physically located. The distant site is the site where the provider providing the service is physically located.