AcuteCare Telemedicine Blog


New Rules for Telemedicine Providers in Georgia

The Georgia Composite Medical Board (GCMB) has approved new rules (360-3-.07) for healthcare providers who are practicing telemedicine in the state.

The new rules require doctors to be licensed in the state of Georgia and, in most cases, to have either seen the patient in person or have a referral from another physician, PA or APRN who has seen the patient in person prior to providing the electronic service. The ‘‘in person’’ rule allows exceptions in cases where a patient has been referred by certain types of providers and agencies, such as public school nurses, a community mental health center, the Department of Family and Children’s Services or law enforcement. The rule also includes a broad exception to the in-person encounter requirement if the care provider ‘‘is able to examine the patient using technology and peripherals that are equal or superior to an examination done personally by a provider within that provider’s standard of care.’’

The exceptions were a departure from previous rules that were under consideration by the GCMB. As reported in the Bloomberg BNA, the original provisions offered little in the way of exceptions to the in-person rule but language was altered on the advice of the Medical Association of Georgia (MAG) and other groups. Dr. Matthews Gwynn, an Atlanta area neurologist and board secretary for MAG, told Bloomberg BNA, ‘‘As a neurologist providing care for stroke patients in emergency situations, I’ve never seen these patients before, so I said you have to have a mechanism to allow us to see these patients de novo. This version of the rules does that.’’

The new rules were also prompted, in part, as a response to a growing abuse of online prescription pain medications by unscrupulous companies selling prescriptions on demand. Georgia instituted the Prescription Drug Monitoring Program in 2013 which allows pharmacists to check to see whether patients are getting prescriptions from more than one doctor or using several pharmacies. Georgia was the second to last state to implement a system to monitor and curb what has become a significant problem all across the country. The new GCMB telemedicine rules specifically exclude the prescription and distribution of controlled substances for the treatment of pain or chronic pain by electronic means.

The GCMB rule requiring telemedicine providers to have a Georgia state license is typical of other states’ requirements. The individual state license rule is often seen as a significant barrier to the accelerated expansion of telemedicine nationwide. Consumer groups traditionally advocate for more open telemedicine policies as a way to improve access to health care for residents of rural areas across the country and in Georgia, where doctors, particularly specialists, are scarce.



Think of Your Brain!

It is without a doubt the most vital organ in the human body, but too often we neglect the importance of taking good care of our brain. The development and organization of the brain are incredibly complex, but the intricacies of this central body belie the simplicity of its proper day to day caretaking. We only get one – why not give some thought (pun intended) to it.

Prevention of traumatic head injuries is likely the most obvious consideration for avoiding significant damage to the brain. Unfortunately, we cannot always predict when an accident might occur, but we can take basic steps like fastening our seat belts while riding in automobiles and wearing helmets when engaging in physical activities carrying risk of trauma. Beneath the skull, we must be concerned with degenerative disorders of the brain affecting motor skills and cognition, such as Alzheimer’s Disease and Parkinson’s. Depression and anxiety also afflict millions of individuals across the country. It is important to remember that although our fast paced, high-stress lives can seem overwhelming, these conditions are chemical, and there are measures we can take to mitigate their negative effects.

Perhaps the most severe threat to the brain is stroke and other cardiovascular disease. The American lifestyle has taken a significant toll on the health of the blood vessels that deliver vital oxygen and nutrients to the brain. We have seen it most exaggerated throughout the southeastern US, a part of the country known as the ‘Stroke Belt,’ where residents face significantly higher rates of stroke morbidity and mortality.

The experts offering advice to citizens on how to minimize their risk of stroke sound like a veritable broken record; sleep more. Eat better. Exercise. Although stroke care has made huge advances in technology and technique over the course of the past decade, there is truthfully no more powerful plan of action than that of prevention. Telemedicine may soon be able to play a bigger role in opening lines communications between physicians and patients at risk of having a stroke, helping them take the necessary steps to avoid an emergency situation where the health of their brain and their life are in danger. As neurologists become more familiar with the advantages of new telemedicine technologies, they are realizing that the “ounce of prevention” is more readily available than ever before.