Physicians who treat and prescribe through advanced communications
technology are practicing medicine and must possess a full Texas medical
license when treating residents of Texas. An out-of-state physician
may provide episodic consultations without a Texas medical license,
as provided in Texas Occupations Code, §151.056, §172.2(g)(4)
of this title (relating to Construction and Definitions), and §172.12(f)
of this title (relating to Out-of-State Telemedicine License).
[(a)Evaluation of the Patient. Distant
site providers who utilize telemedicine medical services must ensure
that a defined physician-patient relationship is established which
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 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),
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 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.]
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
|
