Alaska may soon allow physicians to write prescriptions for many medications without an initial face-to-face encounter between the prescriber and the patient. A bill to allow the remote prescribing process passed on the final day of the state legislative session April 25 and is awaiting the signature of Alaska's Republican Gov. Sean Parnell.
The measure's aim is to enable patients “to obtain over-the-phone or online consultations where physicians can diagnose and, if necessary, provide a prescription,” according to a release by its sponsor, State Rep. Lynn Gattis, a first-term Republican from Wasilla.
The measure would mark a significant change from current state policy.
Alaska currently defines “unprofessional conduct” for a physician to include “prescribing, dispensing, or furnishing a prescription medication to a person without first conducting a physical examination of that person, unless the licensee has a patient-physician or patient-physician assistant relationship.”
Exceptions exist for emergency treatment, expediting partner therapy for sexually transmitted diseases and responding to an infectious-disease outbreak, bioterrorism or a public-health emergency.
Rep. Gattis' bill would amend current law, saying that the state medical board “may not impose disciplinary sanctions on a physician for prescribing, dispensing, or administering a prescription drug to a person without conducting a physical examination” under certain conditions.
Those conditions would include allowing prescriptions to be written if the drug is not a controlled substance, or if it is a controlled substance provided that “an appropriate licensed healthcare provider is present with the patient to assist the physician with examination, diagnosis, and treatment.”
The patient also will have to consent to allowing a copy to be sent of “all records of the encounter to the person's primary-care provider if the prescribing physician is not the person's primary-care provider, and the physician sends the records to the person's primary care provider.”
“Nowadays, much of our life is conducted online or over the phone,” Rep. Gattis said. “In this age where we can do almost everything with a smartphone, it should not be necessary to drive to the doctor's office to have a physical consultation for many common ailments.”
The Alaska Native Tribal Health Consortium, the Veterans Health Administration at the Department of Veterans Affairs, and the military, “already operate telemedicine in Alaska by using a federal exemption,” the Rep. Gattis statement said. “This bill mimics the system already in place for some Alaskans and makes it available to everyone.”
The proposed Alaska law is in apparent variance from a new telehealth policy guidance approved last month by the Federation of State Medical Boards.
That policy states that a physician-patient relationship is needed to engage in telemedicine, but that a qualifying relationship can be created “whether or not there has been an encounter in person between the physician (or other appropriately supervised healthcare practitioner) and the patient.”
In defining telemedicine, however, the federation's new policy states that, for an initial encounter, “Generally, telemedicine is not an audio-only telephone conversation, email, instant-messaging conversation, or fax,” favoring instead, “secure video conferencing or store-and-forward technology.”
Joseph Conn writes for Modern Healthcare, a sister publication of Business Insurance.