[§453-1.3]  Practice of telemedicine.  (a) Nothing in this section shall preclude any physician acting within the scope ofthe physician's license to practice from practicing telemedicine as defined inthis 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-basedcommunication to establish a physician-patient relationship, to evaluate apatient, or to treat a patient.  "Telehealth" as used in chapters431, 432, and 432D, includes "telemedicine" as defined in thissection.

(c)  Telemedicine services shall include adocumented patient evaluation, including history and a discussion of physicalsymptoms adequate to establish a diagnosis and to identify underlyingconditions or contra-indications to the treatment recommended or provided.

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

(e)  All medical reports resulting fromtelemedicine services are part of a patient's health record and shall be madeavailable to the patient.  Patient medical records shall be maintained incompliance with all applicable state and federal requirements including privacyrequirements.

(f)  A physician shall not use telemedicine toestablish a physician-patient relationship with a patient in this State withouta license to practice medicine in Hawaii.  Once a provider-patient relationshipis established, a patient or physician licensed in this State may usetelemedicine for any purpose, including consultation with a medical providerlicensed in another state, authorized by this section, or as otherwise providedby law. [L 2009, c 20, §2]