Telemedicine for Puerto Rico

Governor Wanda Vázquez Garced has signed a bill that will make it easier for medical professionals in Puerto Rico to use telemedicine during the coronavirus pandemic.

What is telemedicine?

Telemedicine apps allow doctors and nurses to meet in real time with patients via their phones or computers. There are apps that make it possible to have these consultations securely as required by HIPAA (Health Insurance Portability and Accountability Act) regulations. HIPAA preserves patient privacy by strictly limiting the ways patient information can be shared. Under normal circumstances, these privacy requirements insist on a secure, HIPAA-compliant connection for video consultations.

For example, health professionals could not use FaceTime or Skype to meet with patients. They could not email a patient a prescription, either, or share information from the patient’s records over the phone.

Doctors using telemedicine apps typically have patients come to a virtual waiting room five to ten minutes before their appointment, and then join the patient via video over the patients’ phones, tablets, or desktop computers. The visit is conducted in the same way as a regular face-to-face office visit, and the doctor has the same access to patient records as he or she would in a regular office visit.

The doctor may ask the patient to move in order to provide a clear view, and the patient can ask all the usual questions. If the doctor finds that a physical exam is necessary, he or she will ask the patient to make an in-person appointment. The doctor can provide a prescription for non-narcotic medications through a telemedicine appointment.

Doctors and  clinics across the country are shifting to telemedicine in order to protect their healthcare professionals and their patients from avoidable physical contact.

What changes under the governor’s new rules?

The new rules allow telemedicine appointments without the level of security normally required by HIPAA. The government will require insurance companies to cover the extra costs normally associated with telemedicine appointments, and to pay for them as though they were ordinary face-to-face appointments.

Pharmacies will also be allowed and required to refill prescriptions for chronic diseases based on the patient’s empty medication bottle rather than waiting for a refill prescription.

The need for telemedicine in Puerto Rico

Many deaths were caused by a lack of medical care following Hurricane Maria. The Puerto Rico Science, Technology and Research Trust and the Puerto Rico Public Health Trust announced a $500,000 grant from the U.S. Department of Agriculture to start a pilot project designed to establish local telemedicine programs in Puerto Rico.

Between this extra funding and the temporary relaxation of rules, Puerto Rico hopes to be able to provide medical care to people in remote areas as well as those with financial and transportation limitations.

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