Telemedicine has been taking the medical world by storm in recent years, and with good reason; it completely revolutionizes the way we practice medicine in the United States of America. Taking its cues from a 1960s initiative that saw doctors linking up with remote patients via telecommunications (which essentially meant ‘phones’ back in the day), telemedicine is a way of providing on-demand health care to patients not just in remote places, but everywhere and anywhere that could benefit from instantaneous communications with doctors and healthcare professionals. As it stands in 2018, telemedicine is almost entirely digitized, and acts as a mediator between patients and doctors. But is it the same in every state in the U.S., and if not, how exactly does the most populous state in the country, the Golden State, deal with it? What is the state of telemedicine in California today?
The first thing to remember when discussing telemedicine anywhere is that it is viewed as a tool in medical practice, not a distinct or separate form of medicine in and of itself. This is very much the case with telemedicine in California, where the utilization and implementation of telemedicine goes back to 1992. That year, the University of California-Davis progressed a telemedicine program based around monitoring fetuses, especially designed for rural communities, which saw a link between the UC Davis Medical Center and a Colusa community hospital. Based on the success of that initiative, Sacramento-based Kaiser Permanente launched a home telemedicine program, while Blue Cross of California and the prison system followed their lead by introducing their own specific telemedicine programs.
In response to this growing demand, the California government decided that new legislature was needed, and a few years later, it passed the Telemedicine Development Act of 1996. This Act set much of the groundwork for the way telemedicine is practiced in the state today, and although it is a relatively new phenomenon in the field of medicine, this important piece of legislature was crucial in getting it up and running in a safe and legal manner. It imposes a few baseline requirements, such as health care plans not necessarily requiring face-to-face contact between patient and doctor (telemedicine in a nutshell), and that every patient on the receiving end of telemedicinal care must sign a written consent form.
A few years later, as digital technology continued to increase and improve, the state of California doubled down on its telemedicine bills and created a new one: The Telehealth Advancement Act of 2011. This Act clarified several definitions in relation to telemedicine in the state, and also expanded the initiative to include the term ‘telehealth’, which provided an umbrella term for telemedicine in general. Most importantly of all, it mandated private payer remuneration for telehealth services, which was a major boost for both patients and doctors alike. It also decreed that meetings between patients and doctors didn’t necessarily have to take place in licensed health care facilities. With this, telemedicine in California became more widely available, and set the framework for expedited growth in the years to come. In a few states, a person-to-person physical exam is required before a doctor and a patient can begin treatment via telemedicine; this is not the case in California, where relationships may be established solely through telemedicine and remain legitimate.
A number of different practitioners can provide telemedicinal care in the state of California – they just have to be licensed under Division 2 of the state’s Healing Arts statute. This remit includes doctors, nurses, chiropractors, midwives, dieticians, nutritionists, dentists, and more. The type of telemedicine available in the state is wide and varied, and can be applied to almost every form of health care available. Everything from clinical consultations to medical marijuana from sites like MMJ Recs constitutes telehealth, bringing California way ahead of the curve when it comes to the initiative. California is also a huge state; this makes it a perfect area to benefit from telemedicine’s other major advantage – the widening availability of specialists.
Previously, especially in rural areas, patients were limited to seeing the specialist who was nearest to them. As many conditions require a specialist, whether they appear serious or not, this was severely limiting for some patients, who might not have had the opportunity to shop around for a specialist that suited them, by necessity of their location. In 2018, there is a huge range of specialists available via telemedicine, and they’re not limited the nearest one available. On top of that, patients can engage with specialists when and where they want to, as opposed to being put on a long list for a physical visit that could be months or even years away.
All in all, the future for telemedicine in California looks bright. Hopefully some other states will start taking some cues from the Golden State, and incorporate its embracing and acceptance of telemedicine into their own programs.