North Dakota Administrative Code › Title 50 - North Dakota Board of Medicine › Article 50-02 - Physician Licensure › Chapter 50-02-15 - Telemedicine › Section 50-02-15-03 - Standard of care and professional ethics

Current through Supplement No. 393, July, 2024
Licensees are held to the same standard of care and same
				  ethical standards whether practicing traditional in-person medicine or
				  telemedicine. Therefore, the following apply in the context of
				  telemedicine:
1. Scope of practice.
				Professional ethical standards require all practitioners to practice only in
				areas in which they have demonstrated competence, based on their training,
				ability, and experience. In assessing a licensee's compliance with this ethical
				requirement, consideration must be given to board certifications and specialty
				groups' telemedicine standards.
2.
				Patient-licensee relationship. A licensee practicing telemedicine shall
				establish a valid relationship with the patient prior to the diagnosis or
				treatment of a patient. A licensee practicing telemedicine shall verify the
				identity of the patient seeking care, and disclose, and ensure the patient has
				the ability to verify, the identity and licensure status of any licensee
				providing medical services to the patient.
3. Evaluations and examinations required to
				establish a patient-licensee relationship. Prior to initially diagnosing or
				treating a patient for a specific illness or condition, an examination or
				evaluation must be performed. An examination or evaluation may be performed
				entirely through telemedicine, if the examination or evaluation is equivalent
				to an in-person examination. A video examination that utilizes appropriate
				diagnostic testing and use of peripherals that would be deemed necessary in a
				like in-person examination or evaluation meet this standard, as does an
				examination conducted with an appropriately licensed intervening health care
				provider, practicing within the scope of their profession, providing necessary
				physical findings to the licensee. An examination or evaluation that consists
				only of a static online questionnaire or an audio conversation may not be
				considered to meet the standard of care.
Once a licensee conducts an acceptable examination or
				  evaluation, whether in-person or by telemedicine, and establishes a
				  patient-licensee relationship, subsequent followup care may be provided as
				  deemed appropriate by the licensee, or by a provider designated by the licensee
				  to act temporarily in the licensee's absence.
It is recognized that in certain types of telemedicine
				  utilizing asynchronous store-and-forward technology or electronic monitoring,
				  such as teleradiology or intensive care unit monitoring, it is not medically
				  necessary for an independent examination of the patient to be performed.
4. Medical records. Licensees
				practicing telemedicine are subject to all North Dakota laws governing the
				adequacy of medical records and the provision of medical records to the patient
				and other medical providers treating the patient.
5. Licensees must have the ability to make
				appropriate referrals of patients not amenable to diagnosis or complete
				treatment through a telemedicine encounter, including those patients in need of
				emergent care, or complementary in-person care.
General Authority:
NDCC 28-32-02
Law Implemented:
NDCC
					 43-17-31