Telemedicine Updates and Recommendations

On an almost daily basis I read something new regarding telemedicine updates and recommendations. The changes I read regarding telemedicine are unprecedented and the fact that President Trump declared a National Emergency makes it easier to forget about the rules and simply do what you can with this opportunity.

Personally, I have answered questions regarding HIPAA and telemedicine and even about using phones for voice interaction between patient and Providers. However, the fact that we have so much leeway doesn’t mean this is the wild west and that common sense can go out the door. Also understand that there are many factors and legislative hurdles you may have to consider before engaging in telemedicine services. For your benefit we are enclosing some of the HIPAA guidance released by the Office for Civil Rights as it regards to COVID 19 as well as our recommendations as you move forward.

HIPAA. HIPAA actually has specific guidance as it relates to Emergencies, yet the COVID 19 resulted in specific guidance from the Office for Civil Rights (OCR). While the guidance is quite extensive some of the highlights include:

  • Telehealth services may be provided, for example, through audio, text messaging, or video communication technology, including videoconferencing software.
  • Covered health care providers will not be subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the good faith provision of telehealth during the COVID-19 nationwide public health emergency.
  • The Notification of Enforcement Discretion does not have an expiration date. OCR will issue a notice to the public when it is no longer exercising its enforcement discretion based upon the latest facts and circumstances.
  • All services that a covered health care provider, in their professional judgement, believes can be provided through telehealth in the given circumstances of the current emergency are covered.
  • Use of public-facing remote communication products, such as TikTok, Facebook Live, Twitch, or a chat room like Slack, which OCR has identified in the Notification as unacceptable forms of remote communication for telehealth.
  • Acceptable venues for telemedicine are considered “non-public facing remote communication”. Examples of acceptable products include platforms such as Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Whatsapp video chat, Zoom, or Skype.

For more information regarding OCR’s guidance visit:

Understand that offering telemedicine services and been able to follow OCR’s guidance is not the same as stating that these services will be covered by all Insurance Companies , Medicare and Medicaid. All they are stating is that they will not impose penalties as it regards to HIPAA Violations made in the good faith provision of telehealth during this crisis.

Note: OCR will prosecute acts that they may consider as bad faith provision.

Recommendations. Even if the rules have been modified during this crisis we recommend some basic rules that should be used as a guidance for all telemedicine Providers.

  1. Use HIPAA approved platforms.
  2. Make sure that telemedicine is provided using a face to face (remote) system.
  3. Document the encounter. A simple paper note will suffice but make sure that the note is legible and that the same have key information you will need to diagnose and create a plan of action.
  4. Obtain consent from your patient.
  5. Protect the information collected.

Regardless of the challenges you may face we strongly recommend the implementation of telemedicine to all Providers and healthcare organizations.