Texas Register

TITLE 22 EXAMINING BOARDS
PART 9TEXAS MEDICAL BOARD
CHAPTER 174TELEMEDICINE
RULE §174.8Evaluation and Treatment of the Patient
ISSUE 04/30/2010
ACTION Proposed
Preamble Texas Admin Code Rule

(a)Evaluation of the Patient. Distant site providers who utilize telemedicine medical services must ensure a proper physician-patient relationship is established that at a minimum includes:

  (1)establishing that the person requesting the treatment is in fact who the person 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. An online or telephonic evaluation solely by questionnaire does not constitute an acceptable standard of care.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on April 19, 2010

TRD-201001895

Mari Robinson, J.D.

Executive Director

Texas Medical Board

Earliest possible date of adoption: May 30, 2010

For further information, please call: (512) 305-7016



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