(a)Evaluation of the Patient. Distant site providers
who utilize telemedicine medical services must ensure that a defined
[proper] physician-patient relationship is established
which at a minimum includes:
(1)establishing that the person requesting the treatment
is in fact who the person [whom he/she] claims
to be;
(2)establishing a diagnosis through the use of acceptable
medical practices, including documenting and performing patient
history, mental status examination, and physical examination
that must be performed as part of a face-to-face or in-person evaluation
as defined in §174.2(3) and (4) of this title (relating to Definitions).
The requirement for a face-to-face or in-person evaluation does not
apply to mental health services, except in cases of behavioral emergencies,
as defined by 25 TAC §415.253 (relating to Definitions) [
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 acceptable medical
practices [appropriate practice] as those in traditional
in-person clinical settings.
(c)An online questionnaire or questions and answers
exchanged through email, electronic text, or chat or telephonic evaluation
of or consultation with a patient are inadequate to establish a defined
physician-patient relationship. [An online or telephonic
evaluation solely by questionnaire does not constitute an acceptable
standard of care.]
The agency certifies that legal counsel has reviewed
the proposal and found it to be within the state agency's legal authority
to adopt.
Filed with the Office
of the
Secretary of State on February 23, 2015
TRD-201500617 Mari Robinson, J.D.
Executive Director
Texas Medical Board
Earliest possible date of adoption: April 5, 2015
For further information, please call: (512) 305-7016
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