Telemedicine was made simple during COVID-19, but not any longer!

After Covid-19, telemedicine became extremely popular, however, there are no restrictions on care that is provided over state lines.

This makes some cancer patients’ follow-up therapies more difficult. Other forms of care, such as mental health therapy and regular doctor visits, may also be impacted.

The Alliance for Connected Care, a group that promotes the use of telemedicine, reports that during the past year, roughly 40 states and Washington, D.C., have stopped emergency declarations that made it simpler for doctors to use video visits to see patients in another state.

For those who already have a relationship with a doctor, several states, including Virginia, have made exceptions. A select number, including Arizona and Florida, have made it simpler for out-of-state physicians to practise telemedicine.

The resulting patchwork of laws, according to doctors, has caused confusion and forced some practices to completely discontinue out-of-state telemedicine. Only patients who can afford to travel for in-person meetings will be able to get follow-up care, consultations, or other services.

Susie Rinehart has scheduled two visits to her Boston-based oncologist in the near future. Rare bone cancer that has progressed from her skull to her spine requires ongoing monitoring through scans and doctor visits.

Rinehart doesn’t have a specialist who can treat her close to where she lives outside of Denver. During the epidemic, these encounters were conducted virtually.

To save money, she’ll travel alone, but if she receives unfavourable news, she’ll be on her own to deal with it.

The 51-year-old stated that having a rare cancer is already stressful, and this only makes things worse.

Dr Shannon MacDonald, Rinehart’s oncologist, noted that compared to before the pandemic, when video visits were still in their infancy, the enforcement of telemedicine laws seemed to be more zealous now.

Having recently co-authored an article about the subject for The New England Journal of Medicine, MacDonald remarked, “It just seems so out of date.”

State medical boards consider the location of the patient during a telemedicine visit to be the appointment site. For virtual visits, Massachusetts General, one of MacDonald’s hospitals, demands that doctors hold valid licences in the patient’s state.

The Mass General Brigham health system also wants those visits to be limited to New England and Florida, where many patients spend the winter.

That doesn’t help medical professionals like MacDonald who treat patients from all across the nation.

Numerous patients travel from outside of Ohio to the Cleveland Clinic. Because winter can bring snowy weather, neurosurgeon Dr Peter Rasmussen is concerned about how certain people would handle impending travel.

For someone with a condition like Parkinson’s disease who has difficulty walking, he said, a fall “actually might be life-ending.”

Telemedicine was made simple during COVID-19, but not any longer!

Finding doctors for patients who relocate out of state is a problem that psychiatrists face differently. For college students who have temporarily moved away from home, this is extremely challenging.

Dr Shabana Khan, chair of the American Psychiatric Association’s telepsychiatry committee, highlighted that there are no child and adolescent psychiatrists in the majority of American counties.

When Khan and his colleagues attempt to transition patients, they frequently find nobody there.

When the post-traumatic stress disorder of Helen Khuri, then 19, flared up this spring, her mother sought out a professional to assist her. The Emory University student had to temporarily relocate from Atlanta to Boston for therapy, despite the fact that she had never entered the facility providing it.

She and her father rented an apartment so that she could attend telemedicine appointments in the same location, which she thought was “crazy.”

Khuri stated, “It didn’t really make sense to… kind of uproot my life, only to do this three-week therapy programme.

Even local patients or doctors may be impacted.

Patients from Maryland have begun travelling a short distance across the border to see Dr Ed Sepe in person at his paediatric practice in Washington, D.C. The 45-minute travel downtown for an in-person visit is avoided as a result.

It’s stupid, he declared. It makes no sense to impose geographic restrictions for telemedicine if you are receiving medical care from a doctor and you are in the United States.

Sepe observed that positions that don’t permit time off for in-person visits are frequently held by families with poor incomes. Others have trouble finding transportation. With these challenges, video visits were helpful.

It’s more extensive than just telemedicine, he declared. “There’s a missed chance to equalise the playing field there,”

According to Lisa Robin, a manager with the Federation of State Medical Boards, states can contribute significantly to the expansion of telemedicine by preventing fraud and ensuring the safety of patients.

The federation, however, also suggests that states relax a few telemedicine-related regulations.

That includes allowing virtual follow-ups for patients who have flown outside of the country for care or for patients who are moving temporarily but want to stick with their current physician.

According to Dr Ateev Mehrotra, a Harvard health policy expert and expert in telemedicine, states might potentially create regional agreements with their neighbours to facilitate cross-border healthcare.

“There are numerous ways that these problems can be resolved,” he stated.

Patients striving to handle their current medical needs are doing so in the meantime.
In order to monitor his uncommon bone cancer, Lucas Rounds is unsure of how frequently he will visit MacDonald in Boston. In order to receive radiation and have surgery earlier this year, the 35-year-old Logan, Utah, resident has spent months away from home.

He must also take into account his wife, three young daughters, and other expenses like a mortgage.

Rounds claim that he needs to consider how he will care for his family “if the worst happens.”

He said that his family would not have the money if he passed away from cancer because of all the costs we’ve racked up.

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