Good morning honorable Chairman Gray, esteemed members of the Committee on Health, and district residents. My name is Timothy Stephens, and I am the public health advisor to Licentiam. Licentiam is a health regulatory technology company building innovative technologies to expedite both the medical licensure process and the sharing of licensing information between states. Mr. Mark Vargas, President of Licentiam, sends his deep regrets for not being here with you today. However, he has asked me to answer any questions the Council may have on how innovative technologies can help medical Boards be more responsive to their applicants and help build the workforce capacity of health professionals in the District.

Today, I’d like to talk about several important disruptors relevant to the licensure of health professionals. The first is the dramatic acceleration of the practice of telemedicine. Consider: in 2013, 350,000 U.S. patients used telemedicine. And, in 2018 it is projected that over 7 million patients will be seen virtually. In terms of economic growth, telemedicine is projected to be a $20 billion industry.

What’s most remarkable is the increase in the number of physicians entering the practice of telemedicine. A recent national survey found that 67% of physicians practice, or plan to practice telemedicine over the next two years. Telemedicine is quickly growing because of the access to medical care it creates for patients, its ability to alleviate health professional shortages and the unprecedented demands on the healthcare system. Additionally, studies have found that telemedicine can help meet health needs for disabled residents and ones who are not physically able to leave their home.

Simultaneous to the explosion of telemedicine is the unprecedented demand for physicians to hold multiple medical licenses in various states they practice. Our Licentiam researchers found that many, if not all the licensing systems used by state Medical Boards, such as the one used by the DC Department of Health, are outdated, causing significant delays and unnecessary vulnerabilities in the licensing process – a source of frustration for both physician applicants, as well as, the excellent employees at DOH that work in the license processing center. But, ultimately, the true sufferers are patients who have less access to medical care. Think about these statistics in DC; the average length of time it takes the DC Board of Medicine to approve a clean license application for a doctor can be up to 60 days. If the average physician sees 15 patients a day, and the annual number of new medical licenses in DC is about 1000 – that’s roughly 900,000 patients that could have seen a doctor during the time it took to manually process and issue a medical license. The core problem is that the licensing systems are using 2001 technologies to address 2017 demands.

The second issue I’d like to discuss is patient safety. Last year, the D.C. Superior Court found a former DC licensed nurse guilty of sexually assaulting three patients in the emergency rooms of 3 DC hospitals between 2013 and 2014. It was previously reported by the Washington Post that the nurse continued to work in D.C. and Maryland despite such allegations, where additional abuse cases could have been prevented if states had shared investigation information. But DC isn’t alone. Just last month, the Tucson Sentinel reported that the Arizona medical boards can take years to penalize doctors who overprescribe.

So, what’s the common denominator? The answer is quite simple: The District and states are still using outdated technologies and licensing systems that restrict government regulators from sharing licensure, investigations and conduct reports across state lines in a timely fashion. The rapid, two-way sharing of information is critical to patient safety! The theme again is – we are using 2001 technologies that are creating a 2017 problem.

In conclusion, I urge this committee to explore ways to integrate innovation and the latest technologies to address these pressing issues. This committee has documented the challenges of diabetes, HIV and other significant comorbid health issues in the District. Moreover, the DC Board of Medicine confirmed the ongoing shortage of qualified physicians in their most recent Physician Workforce Capacity Survey, and reported that both Wards 5 and 7 are fully designated as “Health Professional Shortage Areas”. By addressing known deficiencies in licensing system technologies our entire community and residents can better their access to qualified health professionals. We urge your Committee and the Department of Health to make the District an attractive place for physicians to practice medicine, and telemedicine.