2006 proposed fee schedule - American Society of Clinical Oncology

practitioner) and a patient, we believe that the use of a
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two-way video communication is much less of a departure from
this standard than a one-way video communication, because
the face-to-face interaction between a physician and a
patient allows two-way interactive communication, both
verbally and physically. We are concerned that, without
two-way video, communication of many subtle but important
nuances of the interaction between the physician at the
distant site and patient or clinical staff at the
originating site would be lost, leading to reduced
diagnostic accuracy and the possibility of unfavorable
medical outcomes.
However, we recognize that a timely neurological
evaluation is critical for determining suitability for tPA
treatment. Given the potential for adverse affects, such as
the increased risk of bleeding, the decision to administer
tPA (or not to administer) is crucial in determining the
course of management for the stroke patient. Therefore, we
are currently reviewing the definition of an interactive
telecommunications system and request specific public
comments regarding the added clinical value of two-way
interactive video as compared to one-way video for the
purpose of furnishing telehealth services. We are also
interested in receiving comments as to whether an
interactive audio and one-way video telecommunications