“Telemedicine is changing so fast.” This was the message of Jonathan Linkous, CEO of the American Telemedicine Association (ATA), speaking during the organization’s monthly video update, before delving into the topic of licensing across state lines.

ATA has been keeping a close eye on interstate licensure. If medical practices expand across state lines, the physicians have to obtain multiple state licenses which costs a lot of time, money and effort. It also delays patients’ access to healthcare, Linkous noted.

ATA is promoting reciprocity and the Federation of State Medical Boards has put forth a compact where states would agree upon what is essentially a central paperwork area, he said. Clinicians would send their applications to one place for processing for greater efficiency. Enough states support the effort that ATA has decided not to oppose it. They are, however, pushing certain issues such as the compact must cover all states and whatever is put in place must yield real cost savings. “They can’t just put a fee on top of what physicians pay for state licenses. It costs around $300 million for those physicians who do have more than one license. They also want the center to accelerate the time it takes to get a license. If it meets those criteria then ATA will offer its support.

Linkous there are other proposals floating around Capitol Hill to move toward the reciprocity approach that ATA supports. “We want the problem solved.”

Another issue up for debate is the modalities covered by telemedicine. Preliminary medical board rulings say physicians cannot provide patient care by audio if they don’t have a preexisting relationship with the patient but they can use audio if they’re providing weekend coverage for a colleague. “The whole area is mixed.” After looking at the issue carefully, Linkous said ATA is not going to take a position because we are in a very unstable period where it’s in flux. The medical research on a lot of these things is still underway. We’re going to hold off on endorsing a particular approach until we look at where the research is.”

Consumers want this, he said, so ATA does not want to take a position that could harm the momentum. “We don’t want to interfere. We’re going to highlight some of the research that’s been proven so you and the medical boards and others can make a firm judgment.”

ATA also is starting dialogue with medical record companies to talk about the profitability of some of the information being collected. They want to see how to do a better job of making this information transportable. Data are increasingly collected “yet there is no real pathway decided upon that can consolidate it and look at how data match together.”

ATA is going to pump up its member engagement efforts with newly hired staff. “One of the biggest areas of importance is networking and learning from each other,” said Linkous.

ATA held its first lobby day since 2008, said Latoya Thomas, director of ATA’s State Policy Resource Center. Making 26 visits to Senate offices and 40 Congressional members, ATA representatives handed out advocacy tools grading Medicare which showed that Medicare pales in comparison to most Medicaid state agencies when it comes to telehealth coverage. “Medicare failed,” she said, “while most states earned As and Bs.”