On Thursday, May 18, Oklahoma Republican Governor Mary Fallin signed into law changes to the state's definition of telemedicine and the patient-physician relationship. The bill defines telemedicine as the means to practice health care delivery, diagnosis, consultation, evaluation and treatment, as well as the transfer of medical data or exchange of medical education information by means of a two-way, and real-time interactive communication. 

The new law does not exclude store and forward technologies, but does specify that telemedicine encounters involving store and forward cannot be used to establish a valid physician-patient relationship for the purpose of prescribing opiates.  Moreover, the duties and obligations created by a physician-patient relationship shall not apply until the physician affirmatively meets several conditions, including undertaking efforts to diagnose and treat the patient.  The changes in the new law will become effective on November 1, 2017.