Deputy Executive Director
Center for Telehealth and e-Health Law
he Center for Telehealth and e-Health Law (CTeL), located in Washington, D.C., focuses on telehealth laws, policies and
regulations at the state, federal and international level, with a mission of providing agnostic research to those interested in
been sent over to her nursing team, and her doctor would have
seen it. There would have been no ability to fudge the numbers.
We’ve also found that when you’re in a small community you
don’t want to be seen going to the mental-health therapist or to
the behavioral therapist (if you’re dealing with drug addiction).
Being able to essentially bring that doctor into that patient’s
home or clinic is life-changing.
It sounds like you know about these problems from direct
I grew up an hour outside of Cleveland, Ohio, but I lived in a health-
care desert. Lots of people are kind of in the same boat. My
grandfather had a stroke. There was no stroke specialist available
until the next morning. He passed away from complications of
the stroke but not until 10 years later. If a neurologist was there
that night and gave him TPA (tissue plasminogen activator), the
impact of the stroke likely would have been reduced.
We’re finally in a place where technology exists to start min-
imizing risk and providing patients better access to better quality
You held an event, “Summit Panel Spotlight: The Opioid
Epidemic and the Role of Telemedicine,” earlier this year.
The opioid crisis has hit rural areas especially hard.
What did you learn from the event?
The majority of underserved communities are in rural environments. You have patients located in some very rural populations
that literally have no access to mental or behavioral specialists,
especially the areas that are hardest hit with the opioid epidemic.
To solve some of these problems, they need access to various
specialists. It’s such a desert.
The idea was: Could we use telemedicine to provide this
care? The answer is yes. Mental and behavioral health services
have been used by telemedicine since the start of telemedicine.
The problem is that outdated laws—specifically the Ryan Haight
Act—make it very hard to prescribe controlled substances to
patients that would help recover from being addicted to opioids.
The law was written to curb rogue internet pharmacies, to actually stop patients from being able to access controlled substances
through the internet. It says that the patient has to be in a hospital or clinic setting for the first-time patient encounter. The
provider can come in via telemedicine. That is limiting because
if you’re in a very rural area, you might not necessarily be able
to be in a location that is defined within the act.
What do you see as the biggest benefit to telehealth in rural
It’s transforming how people get access to health care. My
grandmother has diabetes, blood-pressure issues and macular
degeneration. She was asked by her health-care provider to
write down her blood pressure and blood sugar and a couple of
other vital signs every morning. In terms of how she reveres
doctors, it’s God and then doctors. She never wants to disappoint a doctor. So she oftentimes fudged the numbers. She
ended up on not the best of medications. If she had access to
a telemedicine unit in her home the information would have