David Flannery (
Robert Jarrin (
Health Aff (Millwood). 2018 Dec;37(12):2052-2059. doi: 10.1377/hlthaff.2018.05151.
The evolution of digital health is entwined with federal regulation and policy. Whether considering what is or is not a medical device, the reimbursement for digital medical technologies, or physician services under Medicare or Medicaid related to remote patient monitoring or telehealth, the rules and policies governing digital health have not been easy to distinguish. In the face of rapid innovation, it has been difficult to fit these products and services into existing regulations of the Food and Drug Administration and the Centers for Medicare and Medicaid Services, particularly when these frameworks never contemplated what communications technologies can do today. Instead, rules have been misapplied, and in some cases, they have hampered the use of these technologies, depressing the proliferation of associated services. However, regulations have begun to change. We discuss the policy and regulatory changes that have begun to evolve and where they should continue to head.
数字健康的发展与联邦法规和政策紧密交织。无论是考虑什么是或不是医疗设备,数字医疗技术的报销,还是医疗保险或医疗补助计划中与远程患者监测或远程医疗相关的医生服务,管理数字健康的规则和政策都不容易区分。面对快速创新,将这些产品和服务纳入食品和药物管理局和医疗保险和医疗补助服务中心的现有法规一直很困难,特别是当这些框架从未设想过通信技术今天可以做什么时。相反,规则被错误地应用,在某些情况下,它们阻碍了这些技术的使用,抑制了相关服务的普及。然而,监管规定已经开始发生变化。我们讨论了已经开始演变的政策和监管变化,以及它们应该继续朝着哪些方向发展。