| (a) Evaluation of the Patient. Distant site providers who utilize telemedicine medical services must ensure that a proper physician-patient relationship is established which at a minimum includes: (1) establishing that the person requesting the treatment is in fact whom he/she claims to be; (2) establishing a diagnosis through the use of acceptable medical practices, including patient history, mental status examination, physical examination (unless not warranted by the patient's mental condition), and appropriate diagnostic and laboratory testing to establish diagnoses, as well as identify underlying conditions or contra-indications, or both, to treatment recommended or provided; (3) discussing with the patient the diagnosis and the evidence for it, the risks and benefits of various treatment options; and (4) ensuring the availability of the distant site provider or coverage of the patient for appropriate follow-up care. (b) Treatment. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional in-person clinical settings. (c) An online or telephonic evaluation solely by questionnaire does not constitute an acceptable standard of care. |
