Telemedicine Licensure


Discussion

States have historically sought to regulate medicine through the state medical practice act.  Those acts typically have sought to regulate the conditions necessary for the treatment or diagnosis of patients in the state.  The advent of technology has made it easier to have physicians “cross” state lines to consult on or provide medical diagnoses.  Much of that innovation has occurred with telemedicine or the transmitting of health care services via electronic means.  Applications using telemedicine include the sending of medical images, pathology slides, radiographs, interactive video and mental health consultations. 

Since the mid-1990s, states have grown increasingly concerned about regulating services provided by out-of-state physicians.  Starting with Kansas and South Dakota, over 30 states now regulate the practice of medicine across state lines using telemedicine.  Most of these states provide that the out-of-state physician receive a full and unrestricted license in the state in which the patient interaction originated.  Some states provide exceptions for infrequent consultations, emergencies or qualified expertise. 

The ACR has taken a keen interest in telemedicine licensure.  Radiology is the specialty that most frequently uses the technology.  The ACR adopted the first standard on telemedicine (ACR Standard for Teleradiology) in 1994.  The standard has been revised twice.  The standard states that, “the physician performing the official interpretations must be responsible for the quality of the images being reviewed.”  It also notes that, “a diagnostic radiologist should regularly interpret radiographs and other images only when the radiologist reasonably participates in the quality of medical imaging, utilization review, and matters of policy which affect patient care.” 

ACR Position

  • The ACR supports the position that physicians who provide the official interpretation of images transmitted by teleradiology should maintain licensure appropriate to delivery of radiologic service at both the transmitting and receiving sites.  Thus, the ACR supports state licensure for the regular practice of medicine across state lines using teleradiology. 

Contact

For further information on telemedicine or teleradiology licensure, please contact Ariel González at the ACR offices (800) 227-5463, ext. 4488.