[§453-1.3]  Practice of telemedicine.  (a) 
Nothing in this section shall preclude any physician acting within the scope of
the physician's license to practice from practicing telemedicine as defined in
this section.



(b)  For the purposes of this section,
"telemedicine" means the use of telecommunications services,
including real-time video or web conferencing communication or secure web-based
communication to establish a physician-patient relationship, to evaluate a
patient, or to treat a patient.  "Telehealth" as used in chapters
431, 432, and 432D, includes "telemedicine" as defined in this
section.



(c)  Telemedicine services shall include a
documented patient evaluation, including history and a discussion of physical
symptoms adequate to establish a diagnosis and to identify underlying
conditions or contra-indications to the treatment recommended or provided.



(d)  Treatment recommendations made via
telemedicine, including issuing a prescription via electronic means, shall be
held to the same standards of appropriate practice as those in traditional
physician-patient settings that do not include a face-to-face visit but in
which prescribing is appropriate, including on-call telephone encounters and
encounters for which a follow-up visit is arranged.  Issuing a prescription
based solely on an online questionnaire is not treatment for the purposes of
this section and does not constitute an acceptable standard of care.  For the
purposes of prescribing a controlled substance, a physician-patient relationship
shall be established pursuant to chapter 329.



(e)  All medical reports resulting from
telemedicine services are part of a patient's health record and shall be made
available to the patient.  Patient medical records shall be maintained in
compliance with all applicable state and federal requirements including privacy
requirements.



(f)  A physician shall not use telemedicine to
establish a physician-patient relationship with a patient in this State without
a license to practice medicine in Hawaii.  Once a provider-patient relationship
is established, a patient or physician licensed in this State may use
telemedicine for any purpose, including consultation with a medical provider
licensed in another state, authorized by this section, or as otherwise provided
by law. [L 2009, c 20, §2]