Lawmakers in North Dakota have passed new legislation implementing updated protocols on the use of telemedicine in optometry practices across the state.
The law: House Bill (H.B.) 1267.
First, a look at the national stance on telemedicine and optometry.
In response to the growing reliance on—and rapidly changing capabilities of—telehealth as a tool for patient care, the American Optometric Association (AOA) approved an updated Telemedicine in Optometry policy statement in 2022.
Its stance on the subject: The AOA has emphasized its support for telemedicine in optometry, stating that telemedicine can be used to “expand patient access to care, improve coordination of care, and enhance communication among all healthcare practitioners.”
- Even further: It noted that “all individuals should have the opportunity to receive the standard of eye health and vision care regardless of location, socio-economic status, or any other Societal Determinants of Health (SDOH).”
And from an industry perspective?
The use of telehealth services in both optometry and ophthalmology practice has been on the rise over the last few years—as evidenced by the latest innovative developments.
And while we’re on the subject: Last year, The Vision Council (TVC) rolled out a comprehensive teleoptometry regulatory monitoring service for eyecare professionals to track legislation tailored to tele-optometry in all 50 states and the District of Columbia (DC).
- In speaking on the digital service’s launch, TVC’s Michael Vitale stated: “Understanding state regulations for remote eye exams is not only crucial for compliance but also for ensuring that patients receive the highest quality of care regardless of their location.”
Now focus on North Dakota.
First, it’s worth noting that prior to the passing of H.B. 1267, the state’s optometry legislation included zero guidance on telemedicine.
- In fact: Optometric regulations in North Dakota were reported to have remained unchanged for the last two decades.
Enter this bill: The legislation is a product of 2 years of collaboration between the North Dakota Board of Optometry (NDBO), the North Dakota Optometric Association (NDOA), and the state’s attorney general’s office in an effort to clarify “telemedicine standards and [reinforce] patient protections.”
And its purpose?
Testimony in support of the bill stated that its goal is not to change the state’s optometric scope of practice but rather update its statutory language to more modern standards of care—including establishing “necessary guardrails for telemedicine services.”
“Patients deserve safe, regulated access to optometric care, and this bill ensures that providers delivering remote services follow the same high standards as in-person care,” stated Terry Effertz, an attorney from North Dakota-based Integrity Public Affairs, on behalf of the NDOA.
Get into the specifics.
First introduced into the House in January and passed with an overwhelming 130-2 vote in favor, the legislation was signed into law by Gov. Kelly Armstrong on March 24.
Essentially, its purpose included updating, clarifying, and expanding on several services relating to optometry practice.
Among these adjustments, the bill:
- Modifies definitions related to optometry
- Expands the understanding of optometric services to include telemedicine and clarifies the definition of optometry practice
- Extends the time period allowed for student interns from 3 to 6 months following graduation from an optometry school
- Changes the NDBO’s administrative terminology from “secretary” to “executive director”
- Enables the NDBO to establish application, license, renewal, and continuing education fees
- Removes previous requirement for physician consultations for certain eye conditions
- Streamlines licensing process for optometrists (while maintaining standards for professional practice and patient care)
What other telemedicine-specific changes were made?
H.B. 1267 established new provisions for optometry, mandating that patients must first undergo an in-person eye examination by a licensed optometrist in North Dakota before receiving remote (telemedicine) care.
- The reason for this adjustment: To address “ongoing issues with national providers executing online-only vision exams with poor results,” according to Effertz.
She emphasized that the bill’s language does not require the initial relationship to be established in person.
- However: “It does require the optometric services being offered in this state to have a connection to a brick-and-mortar location within our boundaries.”
Why is this stipulation so important?
For the sake of patient safety—particularly as more online tele-optometry services enable customers to order prescription contact lenses or glasses without needing to undergo an in-person eye exam beforehand.
That’s according to Leslie Hellebush, OD, past president of the NDOA, speaking to news outlets.
- “We wanted to make sure that telemedicine is used responsibly in North Dakota, that our patients and our residents get complete comprehensive eye and vision health examinations, and that there were rules laid out for those exams,” she said.
See here for the latest in eyecare legislative news from around the country.
*Disclaimer: The information provided in this article does not and is not intended to constitute legal advice; instead, all information, content, materials available herein are for general information purposes only.