Advertisement
  1. Health

Florida lawmakers to explore telemedicine

Lung X-ray for Pulse story about lung cancer.
Published Feb. 10, 2014

TALLAHASSEE — The doctors at Moffitt Cancer Center use advanced communications technology to diagnose patients in Argentina, Colombia and Brazil.

Helping patients in remote parts of Florida or other states, however, is not so easy.

For one, insurance companies in Florida aren't required to reimburse doctors for telemedicine services, meaning physicians aren't guaranteed payment for Web-based consultations or diagnostic test interpretations. What's more, many doctors don't have the licenses to practice in other states, or the credentials to practice at other hospitals.

"It's a lot easier to do (telemedicine) internationally," said Dr. Karen Fields, Moffitt's medical director for strategic alliances. "But there's a huge market, and there are opportunities in the state of Florida."

The Florida Legislature wants to help.

Over the next few weeks, state lawmakers will consider creating statewide standards for telemedicine. They also will debate establishing reimbursement requirements, as well as a system for registering out-of-state telemedicine providers in Florida.

"Our goal is to create fertile ground for this kind of technology to be used," said state Rep. Jose Oliva, a Miami Republican who chairs the House Select Committee on Health Care Workforce Innovation.

The discussion is taking place as the Legislature shifts its focus from Medicaid expansion, which observers consider unlikely in an election year, to less controversial health care issues like addressing a shortage of primary care physicians.

Telemedicine is hardly a new concept — and is already in use in some Florida hospitals.

At Jackson Memorial Hospital's Ryder Trauma Center in Miami, doctors provide round-the-clock consultation services to five clinics serving U.S. contractors in Iraq, medical director Nicholas Namais said.

Ryder also provides some telemedicine services to patients in Florida.

An example: Trauma surgeons in Miami use the technology to help determine if patients in the Florida Keys should be stabilized in a local hospital or airlifted to Jackson.

Many of Moffitt's telemedicine efforts involve international patients. Highly specialized doctors in Tampa review X-rays and pathology slides, and collaborate with doctors overseas.

Moffitt also has established a network with several other hospitals and health care organizations in Florida. Experts participate in video conferences known as "tumor boards" to diagnose challenging cases.

Fields, the medical director of strategic alliances, said Moffitt would like to use telemedicine to assist more patients in Florida and other states. But the licensing and credentialing issues are daunting.

State law also limits the type of medications that can be prescribed online.

Last week, four experts told a House panel that telemedicine could help patients in rural counties lacking specialists and mental health providers.

Meanwhile, the Senate Health Policy Committee heard a proposal by Sen. Arthenia Joyner, D-Tampa, that would require insurance providers to reimburse telemedicine services as if they were face-to-face encounters with doctors.

The bill also sought to establish standards of care and a process that would enable out-of-state telehealth providers to register in Florida.

After taking public comments, Senate Health Policy Committee Chairman Aaron Bean delayed a vote on the proposal, saying the committee needed another week to revise the language.

There will be many questions to answer moving forward.

Among them: Should telehealth services be reimbursed at the same rate as in-person services?

Tamela Perdue, of the Associated Industries of Florida, cautioned the Legislature against being overprescriptive.

"We certainly love everything to allow the free market to work at its fullest," she told lawmakers last week. "Letting people negotiate for best rates and letting the market do its work is certainly our suggestion."

The Florida Medical Association will be keeping a close watch on licensing issues, lobbyist Holly Miller said.

"Telemedicine should be performed by a licensed physician," she said.

Sen. Eleanor Sobel, a Hollywood Democrat, raised similar concerns about quality last week.

"People in other states do not have the same high standards that we do," Sobel said. "I want to ensure that the health care providers from other states are licensed here in Florida."

Kathleen McGrory can be reached at kmcgrory@MiamiHerald.com.

ALSO IN THIS SECTION

  1. Pharmacist Wendy Sullivan gives a flu shot to Luz Acevedo at the Town 'N Country Senior Center in 2012. The 2019-20 flu season is expected to be a hard one, with Hillsborough County already leading the state in outbreaks. Associated Press
    The county leads the state in flu outbreaks so far this season, prompting an official call for parents to get their kids vaccinated.
  2. An opened capsule containing Kratom. The Clearwater City Council was confronted by dozens of concerned citizens at a recent meeting who urged them not to ban the herbal supplement. Tampa Bay Times
    “I think there was a misunderstanding."
  3. Dr. Philip Adler treated generations of Tampa children, including Hannah Millman, who was 2 years old at the time of this visit. Times (1985)
    The Tampa pediatrician also played a prominent role in desegregating local hospital care.
  4. Reginald Ferguson, center, a resident of the Kenwood Inn in St. Petersburg, talks with Rachel Ilic, an environmental epidemiologist, left, and Fannie Vaughn, right, a nurse with the Florida Department of Health in Pinellas County. The health team was encouraging residents to get vaccinated against hepatitis A, part of a larger effort to address an outbreak of the virus in Florida. SCOTT KEELER  |  Tampa Bay Times
    The effort started in Pinellas, where health department “foot teams” are knocking on doors in neighborhoods at higher risk for the virus.
  5. A nurse at Tampa General Hospital holds a special stethoscope used for critical patients in the Jennifer Leigh Muma Neonatal Intensive Care Unit there. The hospital received a C grade from Leapfrog, an independent nonprofit which ranks hospitals nationally for patient safety. Times (2018)
    Leapfrog, an independent nonprofit, rated hospitals based on hand washing, infection rates, patient falls and other factors.
  6. Most of the time (55%), older spouses are caregiving alone as husbands or wives come to the end of their lives, without help from their children, other family members or friends or paid home health aides, according to research published earlier this year. [Times (2011)]
    Compared to adult children who care for their parents, spouses perform more tasks and assume greater physical and financial burdens when they become caregivers.
  7. “Coming out,” as providers call it, is not easy. But when people ask her specialty, Dr. Jewel Brown of Tampa owns it. She wants to be an abortion provider. Becoming one, she has found, takes determination at every step of the way. MONICA HERNDON  |  Times
    Florida providers seek training and work extra hours to give patients anything they might need.
  8. Nurses at Tampa General Hospital came up with the idea to turn sterile mats used in the operating room into sleeping bags for the homeless. From left are: Lucy Gurka, Claudia Hibbert, Karley Wright and Nicole Hubbard. Courtesy of Tampa General Hospital
    The paper-thin material is waterproof and holds heat, “like an envelope that you can slide into.”
  9. Tampa City Hall. TIM NICKENS  |  Times
    City attorneys intend to appeal a U.S. district judge’s ruling last month overturning Tampa’s ban of a treatment that has been deemed harmful and ineffective.
  10. Messiah Davis, 19 months old, choked on hamburger meat while at a South Tampa child care center and lost oxygen to his brain. He died four days later. His mother has filed a wrongful death suit. Facebook
    Felicia Davis has filed a wrongful death suit, saying Kiddie Kollege failed to save her child and questioning why he was fed hamburger.
Advertisement
Advertisement
Advertisement