US and territory telemedicine policies: identifying gaps in perinatal care

Authors

Ekwutosi M. Okoroh, Centers for Disease Control and Prevention
Charlan D. Kroelinger, Centers for Disease Control and Prevention
Alexander M. Smith, Centers for Disease Control and Prevention
David A. Goodman, Centers for Disease Control and Prevention
Wanda D. Barfield, Centers for Disease Control and Prevention

Date of this Version

2016

Citation

Okoroh EM, Kroelinger CD, Smith AM, et al. US and territory telemedicine policies: identifying gaps in perinatal care. Am J Obstet Gynecol 2016;215:772.e1-6.

Comments

U.S. Government Work

Abstract

BACKGROUND: Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories).

OBJECTIVE: We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified.

STUDY DESIGN: We conducted a 2014 systematic World Wide Webebased review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N=59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis.

RESULTS: Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care.

CONCLUSION: The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource-challenged jurisdictions.