TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Telehealth extensions, especially for controlled substances, are hot topics and here is another Perspectives on this topic. Today’s contribution is from Nate MacLeitch, CEO and founder of QuickBlox, an AI communication platform. He is a seasoned business leader with deep expertise in telecom, media, software, and technology, having held leadership roles at WIN Plc (now Cisco) and Twistbox Entertainment (now Digital Turbine). He also advises and invests in startups and holds degrees from UC Davis and the London School of Economics.
Telehealth’s really made a huge difference in who can get good medical care. By enabling health system leaders to connect more patients to doctors, 91% now report having a telehealth program in place.
Even so, accessibility to prescriptions and proper healthcare remains a critical issue in the US. A systematic review of 185 studies found that 54% of cases indicated how disability or chronic health conditions create barriers to medication access. Race contributed to 28% of reported barriers, while income and education levels were factors in 30% of the studies. Furthermore, half identified a lack of available treatment or healthcare practitioners as a significant structural barrier.
The Drug Enforcement Administration’s (DEA) recent announcement to make permanent three telehealth regulations increases access to vital medical services—particularly addiction treatment, specialized care, and care for veterans. Here’s what telehealth providers need to know.
The DEA’s latest ruling
Telehealth is a necessary avenue to solve accessibility barriers, however, it comes with its own challenges. Patient safety and preventing the diversion of medications into the illicit drug market are at the heart of the DEA’s amendments. See the three latest rules below:
Expansion of buprenorphine treatment via telemedicine encounter
The allowance of initial buprenorphine prescriptions via telephone consultations for up to a six-month supply addresses a critical need in combating opioid addiction. This removes a major barrier for individuals seeking treatment, particularly in rural or underserved areas.
Practitioners must note that the requirement for subsequent in-person visits ensures a balance between accessibility and safe patient care. Further telemedicine prescriptions following this period may be permitted but will first require an in-person visit to a medical provider.
Telehealth platforms should be designed to facilitate these initial consultations, seamlessly integrate with existing healthcare systems, and automatically notify patients and practitioners when the six-month window is completed.
Special registrations for telemedicine and limited state telemedicine registrations
The introduction of special registrations for telemedicine, including the ability for medical practitioners to prescribe Schedule III-V controlled substances without prior in-person evaluations, significantly broadens the scope of telehealth. This helps patients struggling with conditions such as sleep disorders, diarrhea, and anxiety to receive ongoing medication management.
For Schedule II medications, which are more addictive and prone to diversion to the illegal drug market, the DEA established an advanced telemedicine prescribing registration. Certain Schedule II medications are prescribable via telehealth but require the medical practitioner to be board-certified in one of the following specialties: psychiatrists; hospice care physicians; physicians rendering treatment at long-term care facilities, and pediatricians.
While the DEA currently only allows certain types of doctors to use telehealth to prescribe controlled medications, it asks the public to comment on any needs and reasons for expanding this list. The agency’s consideration in making it easier to use telehealth for treating complicated health problems is a good sign for the future of virtual healthcare.
In the meantime, telehealth providers can help clients and partners identify practitioners’ certifications and monitor and restrict prescription types based on their associated authorities within the platform.
Continuity of care via telemedicine for Veterans Affairs patients
The clarification regarding continuity of care for Veterans Affairs patients via telemedicine is a welcome development. By extending the provider-patient relationship established during an initial in-person visit to all US Department of Veterans Affairs (VA) practitioners using telehealth, the VA is streamlining care coordination and improving veterans’ access to required medication.
Telehealth providers must support secure communication and data sharing between platforms and the VA system, further enhancing the continuity of care for veterans.
How automatic notifications can help
Registration renewals, rule updates, prescribing limits, and in-person follow-up deadlines can all be set up as automated alerts to keep practitioners up-to-date and compliant.
Moreover, telehealth platform providers can build in automated alerts that notify practitioners in real-time if a patient has a history of potentially problematic prescriptions. Integrating platforms with electronic databases like the Prescription Drug Monitoring Program (PDMP) helps practitioners identify patients who may be “doctor shopping” (seeking prescriptions from multiple providers).
Strict verification and access controls
In light of the DEA’s latest ruling, telehealth platforms supporting medication distribution will be required to verify that practitioners hold the necessary DEA registrations and any applicable state-specific telemedicine registrations and licenses. This involves confirming that the practitioner’s credentials align with the types of controlled substances they are authorized to prescribe.
Medical licenses, board certifications, and specialized training checks should all be built into the user journey. Telehealth platforms may consider integrating with databases that track practitioner credentials and disciplinary actions, allowing for real-time verification and ongoing monitoring to ensure patient safety and legal practices.
Smart assistants keep practitioners informed
Medical practitioners have a lot of paperwork to keep on top of. From the latest DEA ruling to prescription allowances to patient medical summaries, clicking through platforms and documents can take up time they simply don’t have. Instead, AI assistants help streamline workflows.
Practitioners can use voice commands or chat interfaces to ask the software to retrieve medical information from verified sources. These tools can transcribe patient-doctor telehealth consultations and summarize calls, helping practitioners keep accurate, organized records.
Seamless integration with electronic health records (EHRs), PDMP databases, and other healthcare systems ensures a patient’s complete medical history, prevents outdated data issues, and reduces the risk of doctor shopping. All training data and patient record storage must meet HIPAA regulations to keep patients’ records confidential and eliminate the risk of a data breach.
While the DEA’s regulatory changes offer immense potential, navigating state and federal laws, including varying registration requirements and controlled substance prescribing guidelines, can be challenging. It’s essential to stay at the forefront of these evolving regulations and offer resources and support to your clients and partners, ensuring they can leverage the benefits of telehealth while remaining compliant. Through collaboration and innovation, telehealth providers can improve healthcare access and outcomes for patients and practitioners.
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