Oregon has a reputation for innovation and collaboration on a wide range of issues, from environmental protection to economic development to land use planning. The state is also recognized as a leader in telemedicine due to progressive telehealth programs employed by many of its health care service providers and a supportive state-level public policy.
In 2007, the Oregon Legislature passed a Senate Joint Resolution to begin to build the foundation needed to support the long-term development, adoption, and utilization of telemedicine in Oregon.
The state legislators:
Declare that it is the policy of the State of Oregon to promote and facilitate activities by Oregon’s health care and education communities and their telecommunications providers to develop a network model that provides standards for interoperability, establishes a peering point for all health care and education telecommunications in Oregon and establishes peering agreements among health care and education networks that contain payment structures (SJR 20, 2007).
The Oregon Health Network, with both federal and state funding, has made a significant contribution to this objective by providing a functional telecommunications infrastructure to support health care applications statewide. Despite that infrastructure, significant barriers to the expansion of telemedicine for health care delivery persist, including the reimbursement of services by health benefit plans and the credentialing of physicians to remotely deliver clinical services. In recent years, Oregon has moved to overcome these two barriers and promote the adoption of telemedicine through public policy in statute.
[See also: Oregon's ACO experiment TBD, with HIT.]
In 2009, Governor Ted Kulongoski signed Senate Bill 24 into law which became effective in 2010. Broadly stated, it requires health benefit plans to provide coverage of medically necessary health services provided through telemedicine if the health service is otherwise covered by plan.
In this year’s legislative session, Senate Bills 569 and 604 were passed and signed into law by Governor John Kitzhaber.
SB 569
Requires Oregon Health Authority to adopt uniform credentialing and privileging standards for providers of telemedicine services. Authorizes hospital to accept credentials of telemedicine providers either by agreement with distant-site hospital or by providers meeting credentialing and privileging standards established by authority.
SB604
Requires Oregon Medical Board to establish database for purpose of providing to credentialing organizations information that is necessary to credential persons regulated by board.
These laws will help streamline and make more manageable the processes for credentialing physicians and reimbursing physicians for the services that they provide in Oregon. This legislation was made possible by the collaborative and participative efforts of all the affected parties to address concerns and enable the broad support necessary for passage.
It is clear that our state and nation need new and effective strategies to deliver health care to people where they live, not only for the benefit of individual patients, but for the “economic health” and viability of their communities. Available quality health care is an important component of the quality of life for any community of any size. Telehealth and telemedicine are valuable tools for providing access to quality health care and need to be an integral part of any new health care model.
It is hoped that the Oregon experience will contribute to the realization of that goal.
Previous articles from the OHN series:
OHN's 12 health IT best practices, part 10: Credentialing and privileging
OHN's 12 health IT best practices, part 9: Recruitment and retention
OHN's 12 health IT best practices, part 8: Education
OHN's 12 health IT best practices, part 7: Measurement
OHN's 12 health IT best practices, part 6: Tech support
OHN's 12 health IT best practices, part 5: Information
OHN's 12 health IT best practices, part 4: Implementation
OHN's 12 health IT best practices, part 3: A strategic checklist for connectivity
OHN's 12 health IT best practices, part 2: Collaboration
OHN's 12 best practices for health IT, part 1: Strategy and planning
