Cwiek Mark A, Rafiq Azhar, Qamar Aamna, Tobey Charles, Merrell Ronald C
Central Michigan University School of Health Sciences, Mt Pleasant, MI 48859, USA.
Telemed J E Health. 2007 Apr;13(2):141-7. doi: 10.1089/tmj.2006.0029.
The extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries. This approach is deficient when applied to telemedicine because, with the advent of the Internet and modern technological advances, differences in space and time are rendered nearly meaningless. It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face-to-face medicine, as related to licensure. Although it may be argued persuasively that a national licensure model for telemedicine should be advanced, the political and constitutional hurdles may be too great to overcome. It is therefore recommended that a voluntary, regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests, such as through the Southern Governors' Association or the Western Governors' Association. The benefits to be derived from this approach would include improving access to healthcare and medical specialists, enhancing the quality and timeliness of care, cutting medical costs by moving information instead of people, securing patients' access to medical records and information, and facilitating commercial export of American telemedicine services.
近年来，现代远程医疗应用取得了非凡的成功并不断完善，但50个州辖区过时的执照法将医疗执业限制在特定的州地理边界内，这在一定程度上削弱了这些成果。这种方法应用于远程医疗时存在缺陷，因为随着互联网的出现和现代技术的进步，空间和时间上的差异几乎变得毫无意义。本文建议，在执照发放方面，远程医疗的执业方式应与面对面医疗的执业方式有所不同。尽管可能有人有说服力地主张应推进全国性的远程医疗执照模式，但政治和宪法障碍可能太大而无法克服。因此，建议由已经表现出共同利益的辖区，如通过南部州长协会或西部州长协会，采用自愿的、区域性的地理方法。这种方法带来的好处将包括改善获得医疗保健和医疗专家的机会，提高护理质量和及时性，通过移动信息而非人员来降低医疗成本，确保患者能够获取医疗记录和信息，以及促进美国远程医疗服务的商业出口。
