2006 proposed fee schedule - American Society of Clinical Oncology

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b. Definition of an Interactive Telecommunications System
The Medical College of Georgia (MCG) requested that we
modify our definition of an interactive telecommunications
system for purposes of furnishing a telehealth consultation.
The MCG uses an interactive audio and one-way, real-time
video telecommunications system, over an internet-based
protocol, to furnish consultations for acute ischemic stroke
patients. The physician at the distant site (typically a
neurologist) can see the patient; however, the patient and
physician (or practitioner) in the emergency room who is
with the patient cannot see the neurologist. Under this
model, the neurologist at the distant site examines the
stroke patient in real-time video and reviews CT scans and
other critical laboratory data to assess the stroke
patient's suitability for tissue-type plasminogen activator
(tPA) treatment. The requestor noted that the use of tPA
treatment is restricted to 3 hours after onset of stroke,
and argued that rapid evaluation by a neurologist for stroke
patients located in outlying rural hospitals is crucial.
The requestor believes that the use of an interactive two-
way video system does not provide added benefit to the
consulting neurologist, would be unnecessarily cumbersome,
and noted that the use of one-way video currently prohibits
billing as a telehealth consultation.