Law OK’d to support telemedicine

At Rutland Regional Medical Center on Wednesday, Sara Locke, a nurse practitioner, demonstrated telemedicine examinations on “patient” Lauren Edwards, right, a registered electroencephalogram technician, before Gov. Phil Scott signed a bill into law supporting remote exams. PATRICK MCARDLE/STAFF PHOTO

After a demonstration at Rutland Regional Medical Center, Gov. Phil Scott signed a bill into law that will require insurance coverage of telemedicine services.

Scott signed the bill at the University of Vermont Medical Center in Burlington accompanying a mock examination of “patient” Lauren Edwards by Sara Locke, a nurse practitioner at the Rutland hospital, while Dr. Ajay Tunguturi, a neurologist at UVM, looked on.

Edwards, a registered electroencephalogram technician, said she’s participated in several actual examinations of patients as a health care professional.

The bill signed by Scott requires all Vermont health insurance plans to provide coverage for telemedicine services from health care professionals. The coverage requires those services be covered, with or without a deductible, to the same degree the services would be covered if they were delivered on site and in person rather than through the use of video cameras.

There are some restrictions to the coverage, but they are similar to benefits for other in-person treatment. For example, the insurer may restrict the coverage to health care professionals in their network or require proof the treatment is medically necessary.

The goal is to provide better access for Vermonters to all kinds of health care, according to Rep. William Lippert, D- Hinesburg, chairman of the House Committee on Health Care.

Lippert, who attended the bill signing at UVM, pointed out Wednesday that telemedicine already happens in Vermont, but is authorized to take place only in health care facilities.

“What this allows is the potential for the patient to be in their home and to access contact with a medical practitioner via telemedicine,” Lippert said.

Telemedicine can eliminate the need for long trips to medical facilities, but the law requires that health care professionals use a secure line to transmit and receive the images so no one can access the information.

Lippert said patients are required to give “informed consent,” so they must know the benefits and potential drawbacks of treatment through telemedicine. Patients have a right to know everyone who’s involved in the room so they know who’s witnessing their examination.

While the bill was being created, Lippert said, the health care committee heard from professionals at home health agencies who supported telemedicine because it might allow a visiting nurse to help provide an examination for a patient who is homebound.

Scott said the law would “continue to improve Vermont’s outstanding record of health access.”

“Telemedicine is a win for providers and patients as it connects them without building more offices or hiring more doctors. This is especially important for medical specialists who are often harder to find in rural areas,” he said.

Demonstrating that point, Locke’s “examination” of Edwards showed how a patient could receive a neurology exam from a team of medical professionals, split between Burlington and Rutland, from a hospital room at Rutland Regional.

In partnership with UVM, telemedicine came to the Women and Children’s department of Rutland Regional in 2013 and expanded the next year to be available at the breast care program at the Foley Cancer Center and the neurology department.

Afterward, Locke said her job, when she works with telemedicine patients, is to explain the process and obtain patients’ content and then work with the doctor at the remote location to be sure the doctor has all the necessary information.

Locke said patients take to the examinations “very, very well.”

“Surprisingly, most of our geriatric population that are not as technologyinclined as we are, they actually really, really enjoy it. The turning point for (them) is when they can see the doctor and they can talk to him, just like he’s here. They realize there is no barrier, that we’re not doing anything differently than we would if the doctor was here,” she said.

Locke said patients have remarked that they were comfortable with the process because they know the neurologists at the Rutland hospital.

The Wednesday demonstration was a physical examination, but the process can also be used to provide psychiatric or dental services, Lippert said.


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