Academic Medicine Open Forum

As many of you may be aware, Tom Nasca's letter to the ACGME community yesterday mentioned telemedicine visits and gave the revised definition of Direct Supervision.  The other existing definitions of Indirect w/ Direct Supervision Available and Oversight, already allow for phone/electronic modes of communication.

I have not seen or been able to find guidance from CMS regarding altering the supervision requirements to specifically account for telemedicine - I'm sure they are working on it, but it would good to have that info as soon as possible as many of us scramble to get telemedicine protocols in place.

Most visits in the ambulatory primary care setting are done via Indirect Supervision with Direct Supervision Immediately available.

Any info that you can provide would be immensely helpful.   Given that many students are not currently in clinical rotation across the country, and the concern/prior response from LCME stating that some sort of actual clinical experience will need to be done, I'm also wondering how those of you with prolonged disengagement of your students are handling this.  Like many of you, we have pulled our med students from clinical rotations for 2 weeks, but Hawaii hasn't even surged yet (we anticipate this given our tourism, proximity to Asia and lack of complete shutdown of air travel to this date).

Mahalo for your sharing!  Stay well, everyone. This is a marathon.