Chapter 20: Legal and Regulatory Barriers to Telemedicine in the United States: Public and Private Approaches toward Health Care Reform
The Globalization of Health Care: Legal and Ethical Issues (I.Glenn Cohen ed., Oxford University Press 2013), Forthcoming
37 Pages Posted: 17 Nov 2012
Date Written: 2012
Abstract
The United States spends one-and-a-half times more per person on health care than any country in the world, yet lags behind other industrialized nations in health care system performance. Telemedicine has the potential to play a central role in resolving this ongoing disparity. Defined as “the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status,” telemedicine offers the capabilities to deliver health care across distances at reduced costs while maintaining or even increasing the quality of treatment and services. However, U.S. state legal and regulatory regimes currently inhibit the full realization of telemedicine’s benefits by subjecting interstate telemedicine providers to differing standards and requirements and by creating legal uncertainty in the event of cross-border disputes. These barriers call for a uniform means of redress and regulation.
A combination of public and private approaches should be adopted to accommodate the interstate and international practice of telemedicine. Section I discusses the importance of telemedicine in U.S. health care reform. Section II analyzes legal and regulatory barriers to telemedicine in the United States. Section III offers proposals for a national telemedicine regime, including private and public approaches to uniformity in regulation and dispute resolution mechanisms. Section IV concludes with an assessment of the feasibility of applying such proposals on a global scale. The U.S. experience shares similarities with other nations, and represents a microcosm of the international community’s need and struggle to develop a uniform telemedicine regime, as well as to deploy nontraditional options to resolve the dilemmas of rising costs and discontent in the delivery of quality health care services.
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