Wednesday, a committee heard testimonies on House Bill 1263, a bill which would give certain medical providers and licensed professionals who practice telemedicine the authority to write prescriptions.
Telemedicine is the use of audio and visual equipment to provide medical care. It often serves rural areas, where patients might not have nearby access to a physician.
It is also used for patients who have limited mobility or access to transportation, such as senior citizens.
For the purposes of the bill, which was authored by Rep. Cindy Kirchhofer, R-Beech Grove, telemedicine services are defined as secure videoconferencing and remote patient monitoring technology.
The bill deliberately excludes audio calls, emails and text or instant messages.
John Jesser, vice president of LiveHealth Online, a telemedicine corporation, said not being able to provide a full range of services limits the quality of care LiveHealth can give its Indiana patients.
“If it’s 10 p.m. and someone has a kid with pink eye, they’re just going to be frustrated if they still have to go to a doctor’s office in the morning because they can’t get a prescription,” Jesser said.
Forty-seven states currently allow the practice of telemedicine. Of those states, Indiana is the only one to not allow practitioners to write prescriptions of any kind.
The bill stipulates healthcare providers must have an established doctor-patient relationship and significant diagnostic evidence before writing prescriptions.
They must be fully informed of the patient’s medical history.
If they do write a patient a prescription, they must notify their primary care physician and keep them updated on what medications have been prescribed to the patient.
An overwhelming majority of those who testified supported the bill.
Many of them were medical professionals or administrators, who attested to the legitimacy of care provided through telemedicine and the importance of its immediacy and affordability.
“By maximizing the use of this technology and its services, we can provide the best healthcare for our rural Hoosiers,” said Stephen Wolfe, CEO of Indiana Regional Medical Center.
Those who expressed concerns with the bill recommended several amendments to limit what types of medication can be prescribed and under what circumstances.
Dr. Richard Feldman, a former state health commissioner and program director at Franciscan St. Francis Hospital in Indianapolis, said he is of a neutral mindset regarding telemedicine and HB 1263.
Telemedicine is intended for acute, episodic diagnoses, Feldman said. The danger of the bill is it gives more authority to telemedicine practitioners, threatening in-person medical examinations and the relationships between doctors and patients.
“This opens a door for an ongoing cycle where people can get prescription after prescription without ever being in the physical presence of a physician,” Feldman said. “There’s something extremely necessary about physical examination of patients — the actual laying of hands.”
If the bill passes, many limitations would need to be placed on it, Feldman said.
“How many times can a patient be treated electronically for the same thing, not improve and still receive a prescription?” Feldman said. “Perpetual electronic care is not good medical care. It should be the exception, not the rule.”
The bill is slated to return to the committee for action sometime next week.
