Use of telemedicine amid COVID-19 concerns
NCMB has received numerous questions from licensees who are interested in expanding their use of telemedicine to care for patients amid concerns about the spread of coronavirus disease 2019 (COVID-19).
NCMB’s position on telemedicine is relatively simple – If it is possible to gather sufficient clinical information from the patient during a telemedicine consultation to provide care that meets at least minimum accepted standards of care, then the Board considers it appropriate to use telemedicine. Read the Board’s telemedicine position statement.
Prescribing medications following a telemedicine consultation is a more complex issue, especially when the prescriber determines that controlled substances are indicated. The federal Drug Enforcement Administration (DEA) regulates controlled substances prescribing.
DEA has posted information on its website stating that it will not enforce restrictions on prescribing controlled substances via telemedicine during the national state of emergency related to the coronavirus disease 2019 pandemic. Find this information on DEA’s COVID-19 page, under the heading “Telemedicine”. Licensees are strongly encouraged to read the DEA’s guidance before implementing any changes to how they manage patients.
Finally, it should be noted that standards of care continually shift based on the context in which medicine is practiced. NCMB acknowledges that standards of care in a pandemic may change as the necessity to triage and manage limited resources escalates. To the extent circumstances allow, documenting deviations from typical standards of care may be helpful. However, NCMB’s primary focus is on patient safety and, to the extent documenting care hampers a physician’s ability to care for patients, the Board is unlikely to press licensees on this point.