A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING ARTICLE 5 TO CHAPTER 69, TITLE 40 SO AS TO PROVIDE DEFINITIONS AND REQUIREMENTS CONCERNING THE USE OF TELEHEALTH FOR VETERINARY SERVICES; AND BY AMENDING SECTION 40-69-20, RELATING TO DEFINITIONS CONCERNING THE BOARD OF VETERINARY MEDICAL EXAMINERS, SO AS TO REMOVE AN OBSOLETE DEFINITION.

 

Be it enacted by the General Assembly of the State of South Carolina:

 

SECTION 1.  Chapter 69, Title 40 of the S.C. Code is amended by adding:

 

Article 5

 

Telehealth for Veterinary Services

 

    Section 40-69-510. As used in this article:

    (1) "Tele-advice" means the provision of any health information, opinion, or guidance by a veterinary professional that is not intended to diagnose, treat, or issue prognoses of the physical or behavioral illness or injury of an animal. A veterinarian-client-patient relationship is not required to provide tele-advice.

    (2) "Teleconsulting" means a veterinarian who communicates with a veterinary specialist or other qualified expert using telecommunications technology to gain insight or advice regarding the care of a patient.

    (3) "Tele-education" means the use of information and telecommunications technology for distance learning.

    (4)(a) "Telehealth" means the use of telecommunications technology to provide veterinary services or to collect and deliver veterinary health information or education virtually and can encompass general veterinary services or patient-specific veterinary services.

       (b) "Telehealth" may include tele-advice, teleconsulting, tele-education, telemedicine, telemonitoring, telereferral, telesupervision, teletriage, and other tools that help veterinary professionals deliver veterinary education and services virtually.

    (5) "Telemedicine" means the remote practice of veterinary medicine through the use of telecommunications technology that allows a licensed veterinarian with an established veterinarian-client-patient relationship to evaluate, diagnose, and treat a patient virtually.

    (6) "Telemonitoring" means the use of telecommunications technology to augment veterinary services by collecting and delivering health information from a patient.

    (7) "Telereferral" means a veterinarian with an established veterinarian-client-patient relationship who    refers the client to a veterinary specialist to provide veterinary services using telecommunications technology under the established veterinarian-client-patient relationship.

    (8) "Telesupervision" means the supervision of individuals providing veterinary services using media such as audio, audio-visual conferencing, text messaging, e-mail, or other virtual or digital technologies.

    (9) "Teletriage" means the safe, appropriate, and timely assessment of an animal, or a group of animals, under conditions of uncertainty and urgency, and the possible referral to a licensed veterinarian, after discussion with the individual responsible for the animal or group of animals, using telecommunications technology. A veterinarian-client-patient relationship is not required for such an assessment or referral. "Teletriage" does not include the rendering of a diagnosis but may include the provision of tele-advice.

    (10) "Veterinarian-client-patient relationship" means:

       (a) The veterinarian has recently seen and is personally acquainted with the keeping and care of the animal through an in-person, physical examination of or visit to the premises where the animal is kept.

       (b) The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment.

       (c) The veterinarian has sufficient knowledge of the animal to initiate a general or preliminary diagnosis of the medical condition of the animal.

       (d) The veterinarian is available or has arranged for emergency coverage for follow-up and evaluation.

       (e) The client has agreed to follow the veterinarian's instructions.

       (f) The veterinarian-client-patient relationship lapses when the licensee has not seen the animal within one year.

       (g) The veterinarian-client-patient relationship may extend to other licensed veterinarians working out of the same physical practice location as the veterinarian who established the veterinarian-client-patient relationship if the other licensed veterinarians have access to and have reviewed the patient's medical records.

    (11) "Veterinary specialist" means a veterinarian who is formally recognized as a specialist from a specialty organization that is recognized by the American Veterinary Medical Association's American Board of Veterinary Specialties, or its successor organization, or another association that recognizes veterinary specialists that the state board of veterinary medicine has approved by rule.

 

    Section 40-69-520. (A) Only a veterinarian licensed by the board may establish a veterinarian-client-patient relationship in this State.  

    (B)(1) A veterinarian-client-patient relationship only may be established by an in-person, physical examination of the animal or timely visits to the premises where the animal is kept.

       (2) A veterinary specialist may use telecommunications technology to see a patient under another veterinarian's previously established veterinarian-client-patient relationship pursuant to Section 40-69-560.

    (C) An established veterinarian-client-patient relationship may be maintained through examinations that occur using telecommunications technology in between appropriate in-person, physical examinations or visits to the premises where the patient is kept.

 

    Section 40-69-530. (A)(1) A person must be licensed to practice veterinary medicine in this State in order to practice telemedicine in this State.

    (2) A person who is not a licensed veterinarian in this State and who uses telemedicine to provide veterinary services to animals and individuals responsible for the animals engages in the unauthorized practice of veterinary medicine. Such person is subject to penalties for the unauthorized practice of veterinary medicine provided in this chapter.

    (B) A licensed veterinarian shall employ sound, professional judgment when determining whether to provide veterinary services to a patient through telemedicine and shall use telemedicine only when such use is medically appropriate based on the patient's condition.

    (C) A veterinary professional shall ensure that the technology used when providing veterinary services through telehealth is of appropriate quality to ensure:

       (1) accuracy of the remote assessment of the patient's condition or behavior;

       (2) clear communication with clients; and

       (3) compliance with all relevant privacy and confidentiality requirements.

    (D)(1) A veterinary professional shall obtain consent from the client before providing veterinary services through telehealth and shall record the client's consent in the patient's medical record.

       (2) A veterinary professional using telehealth to provide veterinary services shall inform the client, or the client's authorized representative, of:

           (a) the veterinary professional's name, location, and, if applicable, license number and licensure status;

           (b) whether, in the veterinarian's professional opinion, the patient's condition can be accurately diagnosed or treated using telemedicine; and

           (c) the diagnosis, prognosis, and treatment options for the patient.

 

    Section 40-69-540. (A) A licensed veterinarian using telehealth to provide veterinary services shall conduct all necessary patient evaluations and treatment using the applicable standard of care for those evaluations and treatments.

    (B) A licensed veterinarian shall not recommend treatment or care for an animal based solely on a client's responses to an online questionnaire.

 

    Section 40-69-550. (A)(1) Except as provided in subsection (B), only a licensed veterinarian with an established veterinarian-client-patient relationship may prescribe medication through telemedicine.

       (2) A licensed veterinarian shall use professional judgment when determining if it is appropriate to prescribe medication through telemedicine.

    (B) A licensed veterinarian who prescribes medication through telemedicine is subject to the limitations on prescriptions provided in this chapter.

    (C) A licensed veterinarian who does not have an established veterinarian-client-patient relationship with an animal and its owner may use telemedicine to administer, distribute, or dispense a prescription drug that has been prescribed by another licensed veterinarian who has an established veterinarian-client-patient relationship.

 

    Section 40-69-560. (A) A veterinarian with an established veterinarian-client-patient relationship may refer a patient to a veterinary specialist.

    (B) A veterinary specialist to whom a patient is referred may provide veterinary services using telecommunications technology for the patient and client under the referring veterinarian's veterinarian-client-patient relationship.

    (C) A veterinary specialist to whom a patient is referred shall provide the referring veterinarian with information related to the diagnosis, treatment, and progress of the patient.

    (D)(1) A veterinary specialist to whom a patient is referred shall not prescribe medications to the patient unless the veterinary specialist establishes a veterinarian-client-patient relationship through an in-person, physical examination of the patient.

       (2) The licensed veterinarian with the established veterinarian-client-patient relationship may prescribe medications to the patient after consultation with the veterinary specialist to whom the patient was referred.

 

    Section 40-69-570. A licensed veterinarian shall ensure that a client's privacy and confidentiality are protected when the veterinarian is providing veterinary services using telehealth pursuant to the veterinarian's professional and legal obligations.

 

SECTION 2.  Section 40-69-20(15) of the S.C. Code is amended to read:

 

    (15) "Telemedicine" is an audio, video, or data communication of medical informationReserved.

 

SECTION 3.  This act takes effect upon approval by the Governor.

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