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Telemedicine Services

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Professional Standards Regarding the Provision of Telemedicine Services

Preamble

The College recognizes the role telemedicine plays in providing care and access to care, especially in remote and underserviced areas.

The College maintains jurisdiction over physicians licensed in Nova Scotia regardless of where (i.e., physical location) or how (i.e., in-person or via telemedicine) they practice medicine.

Physicians should be aware that practicing medicine using only electronic communication or across different jurisdictions, may affect their liability protection, and they should disclose such information to their liability protection provider.

Requirements for treating patients via telemedicine vary by jurisdiction. The medical regulatory authority of the jurisdiction where the patient is located may require the physician to hold an appropriate medical licence in that jurisdiction where the care is being delivered.

Physicians licensed elsewhere in Canada may deliver telemedicine to patients in Nova Scotia without having to obtain a Nova Scotia medical licence. These physicians must comply with the licencing requirements and the professional standards of the jurisdiction in which they are licensed.

If the College receives a complaint regarding telemedicine services provided to a patient in Nova Scotia by a physician licensed in another jurisdiction, the College may forward the complaint to the appropriate medical authority.

Professional Standards

Physicians must:

  1. Provide care consistent with accepted standards of practice when using virtual or telemedicine technology while recognizing the limitations of the medium;
  2. Comply with the regulatory requirements of telemedicine in every jurisdiction where they treat patients;
  3. Use their professional judgment to determine whether patient consultation via telemedicine is appropriate in a particular case;
  4. Ensure the physical setting in which the care is provided is safe, appropriate, provides for confidentiality and that support is in place to manage adverse events;
  5. Communicate with referring and other treating physicians, and provide appropriate follow-up care;
  6. Subject to Clause (7) in this standard, exercise caution when providing prescriptions or other treatment recommendations to patients whom they have not examined in person; and
  7. Not prescribe opioids or other controlled medications to patients whom they have not examined in person, or with whom they do not have a longitudinal treating relationship, unless they are in direct communication with another regulated-health professional who has examined the patient.
  8. Physicians must ensure the following:
    1. Security and confidentiality of personal-health information
      Physicians must review the Nova Scotia Personal Health Information Act. Note that certain communication technologies may not adequately protect the security of personal-health information. Physicians may wish to consult with the Canadian Medical Protective Association.
    2. Informed-patient consent
      Physicians must review the College’s Professional Standards and Guidelines Regarding Informed Patient Consent to Treatment. In addition to the requirements of this document, the patient-consent process for telemedicine services must ensure the following information is reviewed by the patient:

      1. Where the physician is located and licensed to practice medicine; and
      2. How the privacy of the patient’s personal health information will be managed.

Definitions

Telemedicine is the provision of medical expertise for the purpose of diagnosis or patient care by means of telecommunications and information technology where the patient and the provider are separated by distance. Telemedicine may include, but is not limited to, the provision of pathology, medical imaging, and patient consultative services (Federation of Medical Regulatory Authorities of Canada, 2010).

 

Recommended Reading

College of Physicians and Surgeons of Nova Scotia

 

Document History

First approved by the Council of the College of Physicians and Surgeons of Nova Scotia: February 2, 2001.
Reapproved in June 2, 2006.
Reapproved with revisions on October 14, 2011.
Re-approved with significant changes (including new section on security, confidentiality and consent): December 13, 2013.
Revised and reapproved on December 14, 2018.