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Review
. 2016 Dec;215(6):772.e1-772.e6.
doi: 10.1016/j.ajog.2016.08.020. Epub 2016 Aug 23.

US and territory telemedicine policies: identifying gaps in perinatal care

Ekwutosi M Okoroh  1 , Charlan D Kroelinger  2 , Alexander M Smith  2 , David A Goodman  2 , Wanda D Barfield  2
Affiliations
Review

US and territory telemedicine policies: identifying gaps in perinatal care

Ekwutosi M Okoroh et al. Am J Obstet Gynecol. 2016 Dec.

Abstract

Background: Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories).

Objective: We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified.

Study design: We conducted a 2014 systematic World Wide Web-based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N = 59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis.

Results: Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care.

Conclusion: The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource-challenged jurisdictions.

Keywords: maternal; neonate; perinatal regionalization; policy; risk-appropriate care; telemedicine.

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Conflict of interest statement

The authors report no conflict of interest. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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