Brannon Janice A, Cohn Ellen R, Cason Jana
American Telemedicine Association's Special Interest Group on Telerehabilitation, License Portability Sub-Committee (Co-chairs).
Int J Telerehabil. 2012 Apr 13;4(1):41-6. doi: 10.5195/IJT.2012.6091. eCollection 2012 Spring.
Telehealth, the use of communication and information technologies to deliver health services, was initially envisioned as a way for persons in rural or remote settings to receive otherwise unavailable healthcare services. Now, in addition to overcoming personnel shortages for underserved populations, telehealth shows promise in meeting the needs of a constantly mobile U.S. society and workforce. Fortunately, telerehabilitation can meet the needs of a mobile society and workforce by enabling continuity of care for individuals who are out-of-town, on vacation, in temporary residence as a university student, or on business travel. Unfortunately, outdated legislative and regulatory policies and inhospitable infrastructures currently stand in the way of a seamless continuum of care. In 2010, the American Telemedicine Association's Telerehabilitation Special Interest Group (TR SIG) convened a License Portability Sub-Committee to explore ways to diminish barriers for state licensure portability with a particular focus on physical therapy, occupational therapy, speech therapy, and audiology. In 2011, the Subcommittee published a factsheet (1) that detailed the challenges and potential solutions that surround the difficult issue of licensure portability. Concurrently, the American Telemedicine Association is advocating for national reform of professional licensure. (2) At the heart of all licensure requirements is the ability to determine who should be granted the authority to practice in a particular profession. This is done by focusing on educational, examination and behavioral requirements that are deemed the minimum necessary to protect the public from harm. States, however, with whom authority for licensure of health professionals rests, have independently defined those minimum requirements. This approach has led to a myriad of requirements that vary from state to state. Licensure portability will best succeed when variability between licensure requirements is minimized and an efficient licensure process exists. In this paper, these two critical factors for licensure portability are referred to as "licensure requirements" and "the credentialing process." Currently the variability between both of these factors is different between professions as well as between jurisdictions. To find the best solution to licensure portability, it is critical to determine which of these two elements create significant barriers for licensure mobility. This document outlines a method for the professions to begin collecting data to pinpoint the areas where agreement and variations exist in licensure requirements and processes between states. Such information will inform efforts towards uniformity.
远程医疗，即利用通信和信息技术提供医疗服务，最初被设想为农村或偏远地区的人们获得原本无法获得的医疗服务的一种方式。如今，除了克服服务不足人群的人员短缺问题外，远程医疗在满足不断流动的美国社会和劳动力的需求方面也展现出了前景。幸运的是，远程康复可以通过为出城、度假、作为大学生临时居住或出差的个人提供持续护理，来满足流动社会和劳动力的需求。不幸的是，过时的立法和监管政策以及不友好的基础设施目前阻碍了无缝的连续护理。2010年，美国远程医疗协会的远程康复特别兴趣小组（TR SIG）召集了一个执照可携带性小组委员会，以探索减少州执照可携带性障碍的方法，特别关注物理治疗、职业治疗、言语治疗和听力学。2011年，该小组委员会发布了一份情况说明书（1），详细阐述了围绕执照可携带性这一难题的挑战和潜在解决方案。同时，美国远程医疗协会正在倡导对专业执照进行全国性改革。（2）所有执照要求的核心是确定谁应有权在特定专业领域执业的能力。这通过关注被认为是保护公众免受伤害所需的最低限度的教育、考试和行为要求来实现。然而，负责卫生专业人员执照颁发的各州已独立界定了这些最低要求。这种方法导致了各州之间各种各样的要求。当执照要求之间的差异最小化且存在高效的执照颁发程序时，执照可携带性将最有可能成功。在本文中，执照可携带性的这两个关键因素被称为“执照要求”和 “认证过程”。目前，这两个因素在不同专业以及不同司法管辖区之间的差异各不相同。为了找到执照可携带性的最佳解决方案，确定这两个要素中哪一个对执照流动性造成了重大障碍至关重要。本文概述了一种方法，各专业可据此开始收集数据，以查明各州在执照要求和程序方面存在一致和差异的领域。此类信息将为实现统一的努力提供参考。
