BILL NUMBER: SB 922	CHAPTERED
	BILL TEXT

	CHAPTER   199
	FILED WITH SECRETARY OF STATE   AUGUST 4, 1997
	APPROVED BY GOVERNOR   AUGUST 2, 1997
	PASSED THE SENATE   JULY 18, 1997
	PASSED THE ASSEMBLY   JULY 14, 1997
	AMENDED IN ASSEMBLY   JULY 8, 1997
	AMENDED IN ASSEMBLY   JUNE 25, 1997
	AMENDED IN SENATE   APRIL 24, 1997

INTRODUCED BY  Senator Thompson

                        FEBRUARY 27, 1997

   An act to amend Section 2290.5 of the Business and Professions
Code, relating to medicine.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 922, M. Thompson.  Telemedicine.
   Existing law regulates the practice of telemedicine, which is the
practice of health care delivery, diagnosis, consultation, treatment,
transfer of medical data, and education using interactive audio,
video, or data communication.
   This bill would change that definition to exclude telephone
conversations and electronic mail messages between a health care
practitioner, as defined, and a patient.  The bill would extend the
rights granted to a patient of telemedicine to the patient's legal
representative.  The bill would revise some of the protections
granted to patients of telemedicine to require that all existing laws
regarding patient access to medical information and copies of
medical records and surrogate decisionmaking, as defined, are to
apply.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 2290.5 of the Business and Professions Code is
amended to read:
   2290.5.  (a) For the purposes of this section, "telemedicine"
means the practice of health care delivery, diagnosis, consultation,
treatment, transfer of medical data, and education using interactive
audio, video, or data communications.  Neither a telephone
conversation nor an electronic mail message between a health care
practitioner and patient constitutes "telemedicine" for purposes of
this section.
   (b) For the purposes of this section, "health care practitioner"
has the same meaning as "licentiate" as defined in paragraph (2) of
subdivision (a) of Section 805.
   (c) Prior to the delivery of health care via telemedicine, the
health care practitioner who has ultimate authority over the care or
primary diagnosis of the patient shall obtain verbal and written
informed consent from the patient or the patient's legal
representative.  The informed consent procedure shall ensure that at
least all of the following information is given to the patient or the
patient's legal representative verbally and in writing:
   (1) The patient or the patient's legal representative retains the
option to withhold or withdraw consent at any time without affecting
the right to future care or treatment nor risking the loss or
withdrawal of any program benefits to which the patient or the
patient's legal representative would otherwise be entitled.
   (2) A description of the potential risks, consequences, and
benefits of telemedicine.
   (3) All existing confidentiality protections apply.
   (4) All existing laws regarding patient access to medical
information and copies of medical records apply.
   (5) Dissemination of any patient identifiable images or
information from the telemedicine interaction to researchers or other
entities shall not occur without the consent of the patient.
   (d) A patient or the patient's legal representative shall sign a
written statement prior to the delivery of health care via
telemedicine, indicating that the patient or the patient's legal
representative understands the written information provided pursuant
to subdivision (a), and that this information has been discussed with
the health care practitioner, or his or her designee.
   (e) The written consent statement signed by the patient or the
patient's legal representative shall become part of the patient's
medical record.
   (f) The failure of a health care practitioner to comply with this
section shall constitute unprofessional conduct.  Section 2314 shall
not apply to this section.
   (g) All existing laws regarding surrogate decisionmaking shall
apply.  For purposes of this section, "surrogate decisionmaking"
means any decision made in the practice of medicine by a parent or
legal representative for a minor or an incapacitated or incompetent
individual.
   (h) Except as provided in paragraph (3) of subdivision (c), this
section shall not apply when the patient is not directly involved in
the telemedicine interaction, for example when one health care
practitioner consults with another health care practitioner.
   (i) This section shall not apply in an emergency situation in
which a patient is unable to give informed consent and the
representative of that patient is not available in a timely manner.
   (j) This section shall not apply to a patient under the
jurisdiction of the Department of Corrections or any other
correctional facility.