Vol. 24 Annals of Health Law 324
with chronic diseases and multiple comorbidities. 359 Overall patient health
has an increased likelihood for improvement because the community care-based model that is utilized at Steward permits patient referral to local resources. 360 This decentralized concept satisfies the distinctive essence of the
Steward network, which constitutes several modest practices spread over
150 communities, versus a consolidated system on one centralized campus. 361 PAs in Steward also engage in group-based patient visits to meet patient needs. 362
In addition to health system changes, technologic developments are impacting PA scope of practice. 363 A key example is the advent and expansion
of telemedicine, which is the transmission of medical information through
various methods in order to improve a patient’s health. 364 With roots dating
back more than forty years to demonstrations of hospitals delivering care to
patients in remote areas, the use of telemedicine has expanded rapidly and
is primed for synthesis into the continuous activities of hospitals, home
health agencies, and private physician offices. 365 Not to be considered as a
distinct and separate medical specialty, telemedicine simply serves as a
complement to the way in which medicine is practiced—a tool for providers. 366 Devices and services associated with telemedicine are usually just
one component of a more substantial investment by healthcare institutions
in clinical care delivery or information technology. 367
States are increasingly recognizing the importance of PAs in telemedicine. 368 For example, in 2010 Texas implemented regulations to include
PAs as both distance and on-site telemedicine providers. 369 Kentucky also
saw improvements to embrace emerging technology and telemedicine
when, in 2013, the Kentucky Board of Medical Licensure updated its defi-
359. Id.
360. Id.
361. Id.
362. Id.
363. See Stephen H. Hanson, Technology Can Extend the Physician Assistant’s Role in
Patient Care, PHYSICIANS PRACTICE BLOG (Jan. 4, 2013), http://www.physicians
practice.com/blog/technology-can-extend-physician-assistants-role-patient-care (Stating that
advances in technology have created HIPAA issues in physician offices when it comes to
physician supervision of staff, especially given the widespread human resource problem in
healthcare).
364. What is Telemedicine?, AM. TELEMEDICINE ASS’N, http://www.american
telemed.org/about-telemedicine/what-is-telemedicine#.VCCF9fldWSo (last visited Nov. 16,
2014).
365. Id.
366. Id.
367. Id.
368. See 22 TEX. ADMIN. CODE §§ 174.1-174.12 (2010) (implementing rules to regulate
the provision of telemedicine within the state).
369. Id.
