Unless otherwise prohibited by law, a valid physician-patient relationship may be established by an allopathic with a patient located in this state through telemedicine, provided that the physician:

1. (1) Holds a license to practice medicine in this state;
2. (2) Confirms with the patient the patient's identity and physical location; and
3. (3) Provides the patient with the treating physician's identity and professional credentials.

4. (4) Must practice telemedicine in compliance with standards established in these rules. In order to be exempt from the face-to-face meeting requirement set out in these rules, the telemedicine encounter must meet the following:

   1. (A) Telemedicine encounters
   2. (B) Equipment and technical standards
5. (i) Telemedicine encounters occur when a physician (distant site) performs an exam of a patient (originating site) when distance separates the patient and health care provider.
6. (ii) If the distant site physician deems it to be medically necessary, they can request a licensed healthcare provider trained in the use of the equipment may be utilized at the originating site to “present” the patient, manage the cameras, any peripheral equipment necessary and perform any physical activities to successfully complete the exam.
7. (iii) A complete medical record must be kept and be accessible at both the distant and originating sites, preferably a shared Electronic Medical Record.
8. (iv) Provisions for appropriate follow up care equivalent to that available to face-to-face patients.
9. (v) Information available to the distant site physician shall be equivalent to an face-to-face encounter and must meet all applicable standards of care for that medical problem including, but not limited to the documentation of a history, a physical exam, the ordering of any diagnostic tests, making a diagnosis and initiating a treatment plan with appropriate discussion and informed consent.
10. (i) Telemedicine encounters shall comply with HIPAA (Health Insurance Portability and Accountability Act of 1996) and ensure that all patient communications and records are secure and confidential.
11. (ii) Telemedicine encounters in this state shall not be used to establish a valid physician-patient relationship for the purpose of prescribing opiates, synthetic opiates, semisynthetic opiates, benzodiazepine or carisoprodol, but may be used to prescribe opioid antagonists or partial agonists pursuant to sections 1-2506.1 and 1-2506.2 of Title 63 of the Oklahoma Statues.
12. (iii) A physician-patient relationship shall not be created solely based on the receipt of patient health information by a physician. The duties are obligations created by a physician affirmatively:
13. (I) Undertakes to diagnose and treat the patient; or

14. (II) Participates in the diagnosis and treatment of the patient.

    1. (C) Technology guidelines
    2. (i) Audio and video equipment, use of audio only shall permit interactive, real-time communications.
15. (ii) Technology shall adhere to HIPAA and HITECH complaince, including entity appropriate Business Associate Agreements in transit and at rest.
16. (iii) Technology shall also include data protection including but not limited to consent for aggregation and/or sale of health data, including de-identified data.
17. (iv) Requirements of 435:10-7-13 (d)(3)(B) and (C) shall also apply to remote patient monitoring as well as synchronous (store and forward) technology.

Added at 31 Ok Reg 1975, eff 9-12-14

Amended at 42 Ok Reg, Number 21, effective 7-25-25