Telehealth has opened many doors for both patients and providers by making healthcare more accessible. One topic that is heavily discussed is prescribing medication via telehealth. Though the practice is heavily regulated and has provided countless people with an easier way to obtain their medication, many people have questions and concerns about the way that it works. Let’s walk through how prescribing medicine via telehealth is both similar and different from the in-person process.
Initial Requirements
First of all, it is usually a requirement that your provider has to see you face-to-face, especially on a new intake visit. You have to provide your full name and date of birth and usually show some kind of identification on the screen. Medications are prescribed electronically directly to the pharmacy, just like they’re done in in-person visits. Most pharmacies don’t accept handwritten prescriptions for controlled substances anymore, so sending medications electronically was very common even before the pandemic and the rise of telehealth.
Controlled Substances
If you’re on a controlled substance such as benzodiazepine or a stimulant such as Adderall, Vyvanse, or Ritalin you have to be seen face-to-face for each visit. Most clinics require monthly visits for controlled substances. Depending on the medication, quantity, dose, and patient history, some clinics will allow you to follow up every two months, but generally, it’s every month.
Also, depending on which medications you’re on, your provider might require monitoring of vitals. If you are on medication that may affect your blood pressure or weight, you may be asked to keep records of these numbers to pass along to your provider. Many patients buy a blood pressure cuff and scale for a low cost at their local pharmacy or on Amazon. Sometimes you will also be expected to get labs done by your primary care to check cholesterol and lipid levels.
The Ryan Haight Act
The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 restricted the practice of remote prescribing. Though it was aimed at battling the opioid epidemic by restricting access to painkillers through online pharmacies, it also limited the ability to prescribe non-pain-related medications virtually.
The Ryan Haight Act has been suspended due to the impact of COVID-19 on in-person appointments. The act used to require anyone using controlled substances to be seen in person at least once every one to two years. Though it has been suspended for now, these regulations could come back into place once the pandemic has fully concluded. If this occurs, patients will have to be seen in the office and not by telemedicine. There have been, however, many strong efforts to make telemedicine permanent, citing its many successes over the course of the pandemic.
Follow-up Visits
When medicine is prescribed via telehealth, your provider will tell you when to schedule a follow-up visit to ensure the success of your prescription. If new medications are being taken and a patient is not yet stable, these visits will usually occur within two to four weeks. If the patient is stable, follow-ups may take place after three to six months. Usually, your provider will make sure that you have enough refills to last until your next visit, as most offices require you to be seen for refills. This is the same type of practice to expect when being prescribed medication in-person. If for some reason this changes (i.e. you need to change your medication type or quantity), you will most likely need to schedule another appointment. In this way, follow-up visits are very similar, whether you are seeing your provider in-person or virtually.
In many ways, prescribing medication has remained quite the same pre-telemedicine as it is now. If you are interested in virtual mental health services, contact me today to schedule your first appointment.