Telemedicine or Telehealth for Acupuncture Practices during Covid-19, an Attorney Point of View – Joseph R. Borich III, J.D

Little doubt exists that telemedicine, or more properly telehealth, is here to stay unless COVID-19 wipes us out, sends us back into the stone age, or so ruins the economy that even this non-face-to-face healthcare treatment is no longer available. The virus has certainly made people afraid to venture out of their homes and turn to video calls. More likely, COVID-19 will result in the expansion of telemedicine, not just in the United States, but around the world, albeit expanding in different ways.

Telemedicine is hardly new. Healthcare providers began experimenting with telemedicine by phone and radio in the early 20th century. In the 1960s and ’70s, NASA funding and the rise of television allowed the possibilities to take shape. Since the 1990s, the increased use of personal devices and the Internet have led to more and more telehealth applications. But resistance to telemedicine has remained, at least until the stimulus of the coronavirus pandemic, based largely on reimbursement issues. And both practitioners and patients have been reluctant to adopt the practice because it eliminates the human touch. For Chinese medicine and acupuncture practitioners, it’s particularly important to have the person-person interactions to perform the four-diagnostic approaches, Inspection, Listening/Smelling, Inquiring and Palpation. One expert summarizes the history and future of telemedicine as follows:

Telemedicine has been used to improve patient outcomes for more than 50-years. Transmission of digital and video imagery, or store-and-forward telehealth, has been a standard of radiologists since the 1980s. But widespread access to broadband has enabled clinicians to offer video consults to their patients as a regular part of their practice. By 2016, more than 60% of healthcare providers offered their patients some form of virtual interaction for services. By 2017, that number had risen to 76%- and it shows no signs of slowing down.

Covid-19 has very quickly mandated that entire health care segments go virtual. Telemedicine lets patients remain inside their homes to slow the spread of the virus and hospitals can better prepare for a surge of patients into emergency rooms and intensive care units. Many acupuncture practitioners started telehealth to help their patients while staying home to avoid spreading of the virus.

So, what are we talking about? Yes, any reader could probably come up with a definition of telemedicine or maybe even telehealth, but for compliance issues, let’s make certain that we know what we are talking about Telehealth is actually the broader concept, although sometimes the terms are used interchangeably. The U.S. Department of Health and Human Services notes that telehealth’s definition is broader in scope than that of telemedicine, covering remote healthcare services that are both clinical and non-clinical. The term “telemedicine,” on the other hand, is limited to remote clinical services. Subsequently, the American Telemedicine Association uses the two terms interchangeably, both encompassing a wide definition of remote healthcare.

But even though telehealth is the broader concept, let’s start with telemedicine.

Although a number of definitions exist, one of a number of accurate ones is “the remote delivery of healthcare services, including exams and consultations, over the telecommunications infrastructure”. Telemedicine allows healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit. Patients can communicate with physicians from their homes by using their own personal technology or by visiting a dedicated telehealth kiosk. A perhaps more simplistic definition is “the treatment of people who are ill, by sending information from one place to another by computer, video, etc.” Note that telemedicine does not include the use of audio­ only telephone, facsimile machine, or email.

Telehealth, on the other hand, is broader, “the use of electronic information and telecommunications technologies to support long-distance clinical health care, professional health-related education, public health, and health administration.”

In summary, The World Health Organization notes the difference between telehealth and telemedicine, “where telehealth uses computer-assisted telecommunications to support management, surveillance, literature and access to medical knowledge, while telemedicine uses telecommunications solely to diagnose and treat patients”.  So, most traditional Chinese medical practices fall under the heading of telehealth and can be used.

Make sure to check with your state of licensure for more details on your state requirements for Telehealth and Telemedicine and how that pertains to Acupuncture and TCM modalities.