Managing the regulatory patchwork governing telehealth

Updated on October 14, 2023
Young male doctor in telehealth concept

North and South Dakota don’t agree on telehealth policy. Neither do Virginia and West Virginia. That’s not due to regional rivalries, it’s just typical of this country’s state-by-state patchwork of regulations governing telehealth.

Fifty states, each with its own legislature, medical communities and interested parties, means different ideas about how telehealth should be regulated. And this patchwork of policies hinders the delivery of telehealth, which plays an increasingly crucial role in the healthcare system.

Though many think telehealth is only a phone or video call between a patient and a provider, there are variations:  

  • Synchronous, or live, telehealth is the most common type and provides real-time, direct provider-to-patient care. Patients and providers interact directly via voice or video. This can include remote monitoring of vitals.
  • Asynchronous, or store-and-forward, telehealth allows for remote, non-real time communication between providers and patients. This allows each to interact at the time most convenient for them. It also lets patients collect health information and send it to be reviewed by the provider. This can be done through texts, emails and questionnaires.
  • Hybrid telehealth contains elements of synchronous and asynchronous, allowing patients to complete a survey or questionnaire if it’s followed by a video or phone call.
  • Remote patient monitoring collects data for later use in a synchronous or asynchronous platform.

While telehealth was available before the Covid-19 pandemic, millions of Americans turned to it beginning in 2020, and telehealth now occupies an increasingly important part of healthcare delivery. It compensates for clinician shortages, addresses some social determinants of health and makes it easier for rural patients to get care they can’t otherwise access.

However, telehealth companies trying to operate in more than one state face the challenge of meeting requirements in multiple jurisdictions. And state laws change regularly, making it difficult for telehealth companies to remain in compliance.   

One nationwide standard is that the telehealth provider must be licensed to practice in the state in which the patient resides. However, that does nothing to make telehealth easier. Quite the opposite, actually. Most providers are licensed to practice in only one or two states, which limits their usefulness to a multi-state telehealth company.

Licensing providers in additional states is expensive and time-consuming for telehealth companies. They must attempt to build a roster of multi-state providers, then manage supply-and-demand issues, making sure they have enough, but not too many, providers licensed in each state they serve.

It’s possible that as telehealth becomes more integrated, state regulations will become more uniform, but it’s unlikely to happen soon. To compensate, telehealth providers are finding it easier to partner with B2B telehealth infrastructure providers that guarantee compliance with state laws, recruit and manage providers and stay current with shifting regulations. By relying on an outside partner to manage the complex regulatory landscape, telehealth providers can focus simply on caring for their patients.

Sheeza Hussain
Sheeza Hussain

Sheeza Hussain is chief growth officer at SteadyMD of St. Louis, Mo.