Following a public hearing last month, the Wisconsin Medical Examining Board approved new rules for the practice of telemedicine. The rules differ notably from its first set of rules proposed in 2015 and considered at a public hearing in January 2016. After receiving criticism on its first set of rules, the Board withdrew them for reconsideration and redrafting. The new rules are a notable improvement and refinement, constituting a more streamlined set of rules designed to balance patient care expectations while fostering innovation in health care delivery. 

The new rules require approval from both the Governor and the Legislature (a process which typically takes approximately four months). After those approvals, the rules will be submitted to the Wisconsin Legislative Reference Bureau for publication, and will take effect the first day of the month following publication.

Provisions of the new rules include the following:

• Doctor-Patient Relationship A valid physician-patient relationship may be established via telemedicine.

• License Required A physician who uses telemedicine in the diagnosis and treatment of a patient located in Wisconsin must be licensed to practice medicine by the Wisconsin medical examining board. The rule still preserves peer to peer consultations.

• Definition of Telemedicine and Technology The rule defines “telemedicine” as the practice of medicine when patient care, treatment, or services are provided through the use of medical information exchanged from one site to another via electronic communications. It does not mandate the use of synchronous audio-video technology, but the equipment and technology must be able to provide, at a minimum, information that will enable the physician to meet or exceed the standard of minimally competent medical practice. Telemedicine does not include the provision of health care services only through an audio-only telephone, email messages, text messages, facsimile transmission, mail or parcel service, or any combination thereof. Physicians who provide health care services by telemedicine are responsible for the quality and safe use of equipment and technology that is integral to patient diagnosis and treatment.

• Standard of Care Physicians are held to the same standards of practice and conduct – including patient confidentiality and recordkeeping – whether health care services are delivered in-person or via telemedicine.

• Internet Diagnosis and Treatment When a physician uses a website to communicate to a patient located in Wisconsin, the physician may not provide treatment recommendations, including issuing a prescription, unless the following requirements are met:

• The physician is licensed to practice medicine in Wisconsin as required under s. Med 24.04.

  • The physician’s name and contact information have been made available to the patient.

  • Informed consent is obtained as required under s. 448.30, Stats., and ch. Med 18.

  • A documented patient evaluation has been performed. A patient evaluation shall include a medical history and, to the extent required to meet or exceed the standard of minimally competent medical practice, an examination or evaluation, or both, and diagnostic tests.

  • A patient health care record is prepared and maintained as required under ch. Med 21.

  • Providing treatment recommendations, including issuing a prescription, based only on a static electronic questionnaire does not meet the standard of minimally competent medical practice.