RELATES TO: KRS 313.101(11),
313.021(1)(c),
313.060(9),
422.317,
42
U.S.C. 1320d-2
- 1320d-8
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
313.021(1)(c) requires the
board to promulgate administrative regulations for any license or registration
the board creates.
KRS
313.060(8) and (9) require
the board to promulgate administrative regulations to provide for the practice
of teledentistry in the Commonwealth of Kentucky. This administrative
regulation establishes requirements and procedures for the practice of
teledentistry.
Section 1. Definition.
"Teledentistry" means the use of electronic and digital communications to
provide dentistry and dental hygiene-related information and
services.
Section 2. Practice of
Teledentistry.
(1) To deliver teledentistry
services in Kentucky, one shall have a current, valid dental or dental hygiene
license issued by the Board of Dentistry. The practice of dentistry shall occur
where the patient is located at the time teledentistry services are
initiated.
(2) This administrative
regulation shall not be construed to alter the scope of practice of any health
care provider or authorize the delivery of health care services in a setting or
in a manner not authorized by KRS Chapter 313. Teledentistry encounters shall
be held to the same standard of care as a traditional in-person patient
encounter.
(3)
(a) A patient shall only be treated via
teledentistry by:
1. A Kentucky licensed
dentist; or
2. A Kentucky licensed
dental hygienist who is supervised by, and has delegated authority from, a
Kentucky licensed dentist.
(b) Any individual may provide any
photography or digital imaging to a Kentucky licensed dentist or Kentucky
licensed dental hygienist for the sole and limited purpose of screening,
assessment, or examination. Anyone providing photography or digital imaging to
a Kentucky licensed dentist or Kentucky licensed dental hygienist shall comply
with the same standards required for the recording of photography or digital
imaging in accordance with
KRS
313.010(11).
(4) A licensee using teledentistry
in the provision of dental services to a patient shall establish the
licensee-patient relationship and conduct an evaluation and history of the
patient.
Section 3.
Informed Consent. A licensee shall, to the extent possible:
(1) Confirm the identity of the requesting
patient;
(2) Verify and
authenticate the patient's health history;
(3) Disclose the licensee's identity,
applicable credentials, and contact information, including a current phone
number;
(4) Obtain an informed
consent from the requesting patient after disclosures have been made regarding
the delivery models and treatment methods and limitations, to include any
special informed consents regarding the use of teledentistry services. At a
minimum, the informed consent shall inform the patient or legal guardian and
document acknowledgment of the risk and limitations of:
(a) The use of electronic and communications
in the provision of care;
(b) The
potential for breach of confidentiality, or inadvertent access, of protected
health information using electronic and digital communication in the provision
of care;
(c) The potential
disruption of electronic and digital communication in the use of teledentistry;
and
(d) The types of activities
permitted using teledentistry services;
(5) Inform the patient or legal guardian that
it is the role of the licensee to determine whether the condition being
diagnosed or treated is appropriate for a teledentistry encounter;
(6) State the requirement for explicit
patient or legal guardian consent to forward patient-identifiable information
to a third party; and
(7) Provide
to the patient contact information for the Kentucky Board of Dentistry and a
description of, or link to, the patient complaint process.
Section 4. Confidentiality. The licensee
shall ensure that any electronic and digital communication used in the practice
of teledentistry shall be secure to maintain confidentiality of the patient's
medical information as required by the Health Insurance Portability and
Accountability Act of 1996 (HIPAA),
42
U.S.C.
1320d-
2
-
1320d-8, and all
other applicable laws and administrative regulations.
Section 5. Dental Records.
(1) Any dental record made through
teledentistry shall be in compliance with
201 KAR
8:540, Section 2(1) and (2).
(2) An informed consent obtained in
connection with teledentistry services shall be filed in the patient's dental
record.
(3) The release of patient
records established during the use of teledentistry shall comply with
KRS
422.317.
(4) The licensee shall document or record in
the file:
(a) The patient's chief
complaint;
(b) The licensee's
differential diagnosis;
(c) The
licensee's recommended treatment plan for the patient; and
(d) A description of all services provided by
teledentistry.
Section
6. Prescribing.
(1) The
indication, appropriateness, and safety considerations for each prescription
for medication, laboratory services, or dental laboratory services provided
through the use of teledentistry services shall be evaluated by the licensee in
accordance with
201 KAR
8:540, Section 3.
(2) A licensee's use of teledentistry carries
the same professional accountability as a prescription issued in connection
with an in-person encounter.
Section
7. Representation of Services. A licensee using teledentistry to
deliver dental services or who practices teledentistry shall not:
(1) Directly or indirectly engage in false,
misleading, or deceptive advertising of teledentistry services; or
(2) Allow fee-splitting for the use of
teledentistry services.