T1 Telehealth is a Mississippi company that provides innovative telemedicine services, but has been limited in the healthcare it can deliver because of government regulations that hampered competition. 

By: Mississippi Center for Public Policy

The Mississippi Justice Institute has been representing T1 Telehealth in its efforts to challenge these regulations. On May 9, 2019, after months of negotiations, the Mississippi State Board of Medical Licensure adopted a new proposed rule that will expand telemedicine services in the state by allowing additional providers to offer telemedicine in the emergency room.

“The new regulations will be a great development, not just for T1 Telehealth, but for all telemedicine providers, for small rural hospitals that rely on telemedicine, and for patients across Mississippi,” said Aaron Rice, the Director of the Mississippi Justice Institute. “The Mississippi Board of Medical Licensure took the right approach to make the regulations fair and to increase access to healthcare in Mississippi.”



In Mississippi, there are 64.4 primary care physicians for every 100,000 residents, far below the national median of 90.8. Many rural hospitals struggle to fund and staff their emergency departments, which require multiple emergency room physicians to take turns covering shifts to ensure 24/7 access. Emergency telemedicine allows these small hospitals to keep their emergency rooms open, by staffing them with physician assistants and advanced practice nurse practitioners. When a patient arrives, an emergency medicine physician in another location uses audio/visual technology and other tools to see the patient, and to instruct the nurse or physician’s assistant on the care that is needed.

The old regulation prohibited physicians from providing emergency room telemedicine services to small hospitals unless they worked at a Level One Hospital Trauma Center with helicopter support. Mississippi only has one Level One hospital in the state, so there was no competition for this service. However, any physician who is board certified in emergency medicine is capable of providing emergency telemedicine services, and is able to transfer a patient by helicopter, regardless of the type of hospital the physician works for. The old regulation locked out companies like T1 Telehealth, which was the first private telehealth company in the state, even though the company saw a need and believed it could provide better emergency telemedicine services. The new regulation will now allow new companies to compete.

“The thing that Americans like better than anything is choice,” said Todd Barrett, CEO of T1 Telehealth. “People want to have the opportunity to say I don’t like that, but there’s this other option I can try and two competitors in a market understand that. They both strive to be the one people are going to call. That makes everything better and cheaper by helping to keep costs down and improve quality. There are two ways to differentiate ourselves and that’s either price or quality. This new regulation allows us to come in and prove ourselves, show how much better it is, what the results are, and how patients benefit.”

For Barrett, innovating in healthcare is all he has ever done. It is what he knows. Since graduating from Pharmacy School in 1988, he has started and sold three pharmacy companies and a technology company, each time sensing and filling a need.

“Can we create something that allows more patients to be treated and made better with less dollars and if it looks like that we’re interested in seeing how we can fit in and make that happen,” Barrett added.

The new proposed regulation will be filed with the Secretary of State to allow time for public comments. It will also be reviewed by the Occupational Licensing Review Commission before becoming final. Once the regulation is finalized, many expect to see a new, vibrant market emerge in the provision of emergency telemedicine services.