LITTLE ROCK — The Arkansas State Medical Board voted Thursday to approve a proposed regulation concerning the online transferal of patients’ medical records after two legislative panels previously declined to review the rule.
The Medical Board voted in June to approve the proposed regulation and one other, both governing the use of audio and video technology to care for patients. But in July the House and Senate committees on public health declined to review the proposals after Bradley Phillips, a lobbyist for Dallas-based telemedicine company Teladoc, spoke against them.
Regulation 38 states that a patient completing a medical history online and forwarding it to a physician is not sufficient to establish the a doctor-patient relationship and does not qualify as “store-and-forward technology,” which under the state’s telemedicine law, Act 887 of 2015, is not restricted by law.
Regulation 2.8 states that a doctor-patient relationship may be established through an examination conducted using real-time audio and video technology that provides at least as much information as the doctor could obtain through an in-person examination.
Phillips told the public health committees in July that the language about store-and-forward technology, which was recommended by the state Medical Society, was approved by the Medical Board at the last minute and was not in the regulation during a required public-comment period.
Kevin O’Dwyer, attorney for the Medical Board, said at the time that addition of the language on store-and-forward technology was not a substantive change and did not require a new public-comment period.
Last month, the Administrative Rules and Regulations Committee voted to approve Regulation 2.8 but sent Regulation 38 back to the Medical Board for a new public-comment period. That public-comment period was held, and on Thursday the board approved the regulation in a voice vote with no “no” votes heard.
Robert Baratta, representing Teladoc, told the board Thursday, “This additional time gave all interested parties, including us, time to review the proposed amendments and make informed judgments on the effect those changes make. After careful review, Teladoc does support the proposed rule as presented.”
Claudia Tucker, vice president of governmental affairs for Teladoc, said later in a phone interview the company had been concerned about the regulation because of a “lack of transparency” when the board initially approved it and because of a concern that it would prevent a doctor from reviewing a patient’s medical history before a consultation if the information was transmitted electronically by the patient.
The process was “more transparent this time,” and the board has alleviated the second concern as well, Tucker said.
“In conversations that I have had subsequently to the last meeting, they have said that they agree that the physician should review the patient’s medical history, medical data, before a consultation takes place. They just don’t want to call it store-and forward technology,” she said. “If they want to call it something else, as long as it’s done, we’re okay with that.”
Teladoc and similar companies cannot operate in Arkansas under their present model because of a provision in Act 887 that requires a patient to be at the site of a health-care professional to receive treatment via telemedicine — a requirement that no other state has. Tucker said the company will lobby for a change to the law during the legislative session that begins in January.
Regulation 38 still needs legislative approval before it can be implemented.