Last updated 02/28/2021
Consent Requirements
Informed consent must be obtained to establish a physician-patient relationship over telehealth.
SOURCE: Title 24, Sec. 1769D & DE Code Title 24, Sec. 1933. (Accessed Feb. 2021).
Before services are provided through telehealth, the licensee shall obtain written, informed consent from the patient, or other appropriate person with authority to make health care treatment decisions for the patient. For the purpose of this subsection, written consent includes an electronic signature. At minimum, the informed consent shall inform the patient and document acknowledgement of the risk and limitations of:
- The use of electronic communications in the provision of care;
- The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and
- The potential disruption of electronic communication in the use of telehealth.
SOURCE: 24 DE Administrative Code 2600. (Accessed Feb. 2021).
Informed consent required by Boards (see regulation citations in Professional Board Standards tab).
Last updated 02/28/2021
Cross State Licensing
No Reference Found
Last updated 02/28/2021
Definitions
Applies to: Physical Therapy “Telehealth, as set forth in the Board’s rules and regulations, means the use of electronic communications to provide and deliver a host of health-related information and healthcare services, including physical therapy and athletic training related information and services, over large and small distances. Telehealth encompasses a variety of healthcare and health promotion activities, including education, advice, reminders, interventions, and monitoring of intervention.”
SOURCE: DE Code. Title 24, Sec. 2602 & 24 DE Administrative Code 2600.(Accessed Feb. 2021).
Applies to: Physicians, Podiatry, Optometry, Chiropractic, Dentistry, Nursing, Occupational Therapy, Mental Health, Psychology, Dietetic and Nutrition Therapy, Pharmacy, and Clinical Social Work
“Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.
SOURCE: DE Code. Title 24, Sec. 2002. (Accessed: Feb. 2021)
Applies to: Physicians, Podiatry, Optometry, Chiropractic, Dentistry, Nursing, Occupational Therapy, Mental Health, Chemical Dependency Professionals, Psychology, Dietetic and Nutrition Therapy, Clinical Social Work, and Professional Art Therapists
Telemedicine means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual or other telecommunications or electronic communications, including the application of secure video conferencing or store-and-forward transfer technology to provide or support healthcare delivery which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.
SOURCE: DE Code Title 24, Sec. 1702, Sec. 502, Sec. 701, Sec. 1101, Sec. 1902, Sec. 2002, Sec. 2101, Sec. 2502, Sec. 3002, Sec. 3060, Sec. 3502, Sec. 3802, & Sec. 3902. (Accessed Feb. 2021)& DE Code Title 24, Chapter 30, Sec. 3002. (Accessed Feb. 2021).
Applies to: Mental Health and Chemical Dependency Professionals
“Telemedicine” means a form of telehealth which is the delivery of clinical health-care services by means of real time 2-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health-care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.
SOURCE: DE Code Title 24, Chapter 30, Sec. 3002. (Accessed Feb. 2021).
NOTE: DE Professional Boards each have a different definition of telehealth/telepractice/telemedicine. See Miscellaneous section for references.
Last updated 02/28/2021
Miscellaneous
No Reference Found
Last updated 02/28/2021
Online Prescribing
Pharmacists are prohibited from dispensing prescription drug orders through an Internet pharmacy if the pharmacist knows that the prescription order was issued solely on the basis of an Internet consultation or questionnaire, or medical history form submitted to an Internet pharmacy through an Internet site.
SOURCE: DE Code, Title 16 Sec. 4744(d)(1)(a). (Accessed Feb. 2021)
APRNs and Physicians
Establishing a proper provider-patient relationship includes:
- Verifying the location of and to the extent possible, the identity of the requesting patient;
- Disclosing the provider’s identity and credentials;
- Obtaining consent;
- Establishing a diagnosis through acceptable medical practices, including a physical exam;
- Discuss with patient the diagnosis;
- Ensure availability of distant site provider or coverage of patient for follow up care; and
- Provide written visit summary to patient.
Without a prior patient-provider relationship, providers are prohibited from issuing prescriptions based on internet questionnaire, internet consult or a telephone consult.
Prescriptions through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations set by the Board.
SOURCE: Title 24, Sec. 1769D(b) & DE Code Title 24, Sec. 1933(b)(4)(g). (Accessed Feb. 2021).
Physicians
Prior to a diagnosis and treatment, a physician using telemedicine must either provide:
- An appropriate in-person exam;
- Have another DE licensed practitioner at the originating site with the patient at the time of diagnosis;
- Diagnosis must be based using both audio and visual communication; or
- The service meets standards of establishing a patient-physician relationship included as part of evidenced-based clinical practice guidelines in telemedicine developed by major medical specialty societies.
After a relationship has been established, subsequent treatment of the same patient with the same physician need not satisfy the limitations of this section.
This section shall not limit the practice of radiology or pathology.
SOURCE: Title 24, Sec. 1769D(h)(i)(j). (Accessed Feb. 2021).
A remote, audio-only examination is not an “appropriate in-person examination”.
No opioid prescribing is permitted via telemedicine with the exception of addiction treatment programs offering medication assisted treatment that have received a Division of Substance Abuse and Mental Health (DSAMH) waiver to use telemedicine through DSAMH’s licensure or renewal process. All other controlled substance prescribing utilizing telemedicine is held to the same standards of care and requisite practice as prescribing for in-person visits.
For formation of the physician-patient relationship using audio and visual communications, the audio and visual communications must be live, real-time communications.
SOURCE: DE Admin Code. Sec. 1700. Sec. 19. (Accessed Feb. 2021).
Last updated 02/28/2021
Professional Board Standards
Physical Therapists and Athletic Trainers
SOURCE: DE Statute Title 24, Sec. 2602 (Accessed Jan. 2021).
Board of Mental Health and Chemical Dependency Professionals
SOURCE: DE Admin. Code Title 24, Sec. 3002 (Accessed Feb. 2021).
Board of Clinical Social Work Examiners
SOURCE: 24 DAC 3902 & 3920. (Accessed Feb. 2021).
Respiratory Care Practice Advisory Council
SOURCE: 24 DAC 1769D. (Accessed Feb. 2021).
Board of Examiners in Optometry
SOURCE: 24 DAC 2101. (Accessed Feb. 2021).
Board of Occupational Therapy Practice
SOURCE: 24 DAC 2002. (Accessed Feb. 2021).
Board of Dietetics/Nutrition
SOURCE: 24 DAC 3802 (Accessed Feb. 2021).
Board of Dentistry and Dental Hygiene
SOURCE: 24 DAC 1100 (Accessed Feb. 2021).
Pharmacy
SOURCE: 24 DAC 2500 (Accessed Feb. 2021).
