In an effort to build confidence in the growing telemedicine industry and to set down meaningful applications for consumers and physicians, the American Telemedicine Association is working toward an autumn launch of an accreditation program for primary care and urgent care. The guidelines reflect an industry navigating between wanting to expand its use as well as setting parameters for it.
ATA President Edward Brown referenced the accreditation program in a speech at the ATA conference in Baltimore this week. Brown, who also heads up the Ontario Telemedicine Network, has said the program is needed to help consumers make good choices and to reassure patients that online medical consultations are convenient and safe. It published a draft document earlier this month and is seeking public comment through June 12.
Broadly, the guidelines spell out that telemedicine in primary care settings should treat uncomplicated conditions or be used for simple or routine follow-up for patients with underlying chronic conditions.
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For primary care, the draft guidelines say telemedicine should be used for medical conditions such as allergies and asthma, influenza, low back pain, and upper respiratory infections.
One of the biggest challenges will be in mastering the gray areas that will inevitably come up. For example, although primary care telemedicine sessions might begin with people who are mildly ill, that could quickly worsen depending on the condition. In a series of charts outlining when telemedicine for primary and urgent care is appropriate and when it’s not, it’s notable that asthma is on the list for primary care. And yet, among the things telemedicine shouldn’t be used to treat are acute or chronic shortness of breath, according to the draft guidelines.
Still, it’s about severity and context more than a flat yes or no. For example, rashes accompanied by a fever would merit more urgency than rashes on their own, which would fit under a primary care telemedicine visit.
Some of the interesting quandries the recommendations touch on include vision and hearing difficulties for some patients. Cognitive ability in seniors is another concern — if geriatric patients are too disoriented by, say, a video conferencing interaction, then it’s probably not a good idea.
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