Page 8 - Part 2 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

Establishing a Physician-Patient Relationship

For many legal purposes, it is critical to know whether a bona fide

provider-patient relationship existed at the time of a given event.
This relationship entails specific duties and accountability. Most

authorities are clear that telemedical activity, including
consultation, diagnosis, treatment or rendering advice occurs in

the context of a professional relationship that falls under the

applicable rules and standards for the practice of medicine.
However, States differ about whether the patient-provider

relationship can be established for the first time via telemedicine

without a prior in-person visit. In Arkansas, for example, a patient
must be seen in the office, subject to some exceptions, prior to the

establishment of a relationship by telemedicine. In Tennessee, for
1
example, this is not a requirement. In Kentucky, the relationship is

“clearly established when the physician agrees to undertake

diagnosis and treatment of the patient, and the patient agrees to
be treated, whether or not there has been an encounter in person

between the physician . . . and patient.” The physician-patient
relationship may be established using telemedicine.

In general, if a provider provides services that meet the definition

of telemedicine, that may be enough to create a patient-provider
relationship. Neither express, written consent nor an agreement

1 Arkansas Code Annotated section 17-80-403 (2017) provides when “the establishment of the professional
relationship is permitted via telemedicine[,] . . . telemedicine may be used to establish the professional relationship
only for situations in which the standard of care does not require an in-person encounter.” Arkansas State
Medical Board Regulation No. 2.8 (cross-referenced in Regulation No. 38) requires, in the telemedicine context, in
order to establish a patient-physician relationship, that the “physician performs a face to face examination using
real time audio and visual telemedicine technology that provides information at least equal to such information as
would have been obtained by an in-person examination.”
Full text of KY Board of medical licensure’s Board Opinion Regarding the Use of Telemedicine Technologies:
https://kbml.ky.gov/board/Documents/Board%20Opinion%20regarding%20The%20Use%20of%20Telemedicine
%20Technologies%20in%20the%20Practice%20of%20Medicine.pdf.
Full text of Senate Bill No. 112: http://apps.sos.ky.gov/Executive/Journal/execjournalimages/2018-Reg-SB-0112-
2550.pdf.

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