(a)A health professional providing
a health care service or procedure as a telemedicine medical service:
(1) is subject to the same standard of
care that would apply to the provision of the same health care service
or procedures in an in person setting;
(2)must establish a practitioner-patient
relationship; and
(3)must maintain complete and accurate
medical records as set out in §165.1 of this title (relating
to Medical Records).
(b)Adequate measures must be implemented
to ensure that patient communications, recordings and records are
protected consistent with Federal and State privacy laws.
[(a)Telemedicine medical services
provided at an established medical site may be used for all patient
visits, including initial evaluations to establish a defined physician-patient
relationship between a distant site provider and a patient.]
[(b)For new conditions, a patient
site presenter must be reasonably available onsite at the established
medical site to assist with the provision of care. It is at the discretion
of the distant site physician if a patient site presenter is necessary
for follow-up evaluation or treatment of a previously diagnosed condition.]
[(1)A distant site provider may delegate tasks and
activities to a patient site presenter during a patient encounter.]
[(2)A distant site provider delegating tasks to a
patient site presenter shall ensure that the patient site presenter
to whom delegation is made is properly supervised.]
[(c)If the only services provided
are related to mental health services, a patient site presenter is
not required, except in cases of behavioral emergencies, as defined
by 25 TAC §415.253 (relating to Definitions).]
[(d)For the purposes of this chapter
the following shall be considered to be an established medical site:]
[(1)The patient's home, including a group or institutional
setting where the patient is a resident, if the medical services being
provided in this setting are limited to mental health services;]
[(2)For medical services, other than mental health
services, to be provided at the patient's home, including a group
or institutional setting where the patient is a resident, the following
requirements must be met:]
[(A)a patient site presenter is present;]
[(B)there is a defined physician-patient relationship
as set out in §174.8 of this title (relating to Evaluation and
Treatment of the Patient);]
[(C)the patient site presenter has sufficient communication
and remote medical diagnostic technology to allow the physician to
carry out an adequate physical examination appropriate for the patient's
presenting condition while seeing and hearing the patient in real
time. All such examinations will be held to the same standard of acceptable
medical practices as those in traditional clinical settings; and]
[(D)An online questionnaire or questions and answers
exchanged through email, electronic text, or chat or telephonic evaluation
of or consultation with a patient do not meet the requirements for
subparagraph (C) of this paragraph.]
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 September 1, 2017
TRD-201703487 Mari Robinson, J.D.
Executive Director
Texas Medical Board
Earliest possible date of adoption: October 15, 2017
For further information, please call: (512) 305-7016
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