The pressures to reduce healthcare costs and improve access have never been greater. Everything from the Affordable Care Act to the "Silver Tsunami" of aging baby boomers requires a transformation of the healthcare delivery system.

Telemedicine, having proven its value in rural and remote communities, is increasingly being adopted — including for urban areas with shortages of specialists and in other innovative programs where face-to-face encounters increase cost or risk, or limit access.

While telemedicine and other virtual forms of medical care are quickly being recognized as powerful solutions to the challenges healthcare professionals and patients face, barriers to more widespread adoption remain. One of these is the long and complex process of obtaining licensure for physicians in the various states where patients are located.

A recent survey in Telemedicine and e-Health of those who submit applications for licensure highlights the challenges which cause delays and increased costs. The respondents represented individuals who have an average of 8.4 years of experience with state medical licensing processes in all 50 states, and 58 percent submit more than 100 applications per year.

The top expectations of the surveyed health professionals are:

  • responsiveness to questions (96 percent)
  • cooperation (92 percent)
  • willingness to expedite the application (79 percent)
  • knowledge (79 percent)

Unfortunately, state medical boards are often or always observed for these expectations only at the following rates:

  • responsiveness (29 percent)
  • cooperative (50 percent)
  • willingness to expedite (12.5 percent)
  • knowledgeable (67 percent)

Other findings from the research, published in the survey report published in the journal of Telemedicine and eHealth include:

Looking at how the different states compare to each other, the researchers also find:

  • The actual processing time aligns closest with the estimate advertised by the boards in Washington and Wyoming
  • States that sometimes or always take longer than their advertised estimated time are Texas, California and Illinois
  • The state medical boards rated as the most reasonable are Indiana (64 percent) Oregon (46 percent), Wyoming (46 percent), Pennsylvania (43 percent) and Montana (42 percent)
  • The states that are the most difficult to deal with are California (67 percent), Texas (60 percent), Arkansas (54 percent), Massachusetts (50 percent) and Mississippi (47 percent)
  • Michigan and Indiana are recognized for their "best practices"

Healthcare providers are expected to continually improve their performance improving access and becoming more efficient and effective. To be successful, they need state medical boards to innovate and find ways to minimize the delays in processing application requests and improve their service to the customers they serve. Streamlining and standardizing processes across state lines will help reduce delays even further and contribute to improved access for the patients in their state.

Suggestions from those surveyed for improvement for timely licensure of physicians by state medical boards include the ability to check online for status, accepting Federation Credentials Verification Service (FCVS), electronic and standardized license applications, reciprocity and universal licensure.