At TeleQuality, we talk a lot about telemedicine. We know telemedicine can change healthcare systems and save lives when executed properly. But with so many factors surrounding and clouding the telemedicine market, what does the state of telemedicine look like in 2017? Let’s break down some trends and hurdles we are seeing to telehealth implementation in this post.
Know Your Telemedicine Types
While there are varying definitions of telemedicine, it’s widely accepted definition is the use of medical information shared from one site to another via electronic communications to deliver health care services and improve a patient’s clinic status. The American Telemedicine Association (ATA) includes “a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology” in its definition. Some entities such as the Health Resources Services Administration (HRSA) make a distinction between telehealth and telemedicine, with telehealth referring to a broader scope of remote healthcare services and telemedicine referring to specifically remote clinical services; however, the debate is widely contested and many organizations use the terms interchangeably. The current four categories for telemedicine are:
- Live Video Conferencing- this is the most well-known type, consisting of a patient and healthcare provider using live audiovisual two-way video conferencing session for care, similar to Skype or Facetime calls. This method is often used to treat common illnesses, assist with triage decisions regarding if a person needs to go to an emergency room and with psychotherapy sessions.
- Store-and-Forward (Asynchronous transfer)- this type involves the transmission of a patient’s record or data to a healthcare provider using electronic communications system and treating the patient outside of real time. This method is widely used in rural areas where primary care providers send patient data to specialists at another location for consultation and analysis.
- Remote Patient Monitoring (RPM)- RPM is the collection and transmission of a patient’s health and medical data in real time to a caregiver, nurse or physician in another location for monitoring purposes. RPM is already a highly effective method used in the senior living health industry to help monitor vital statistics and prevent negative health outcomes.
- Mobile Health (mHealth)- this type involves using any mobile communications device, including smartphones and tablets, along with hundreds of software applications to support healthcare.
Patients Want Telemedicine
As with any new technology, consumers must be willing and ready to use it and with telemedicine the answer is clear: patients and consumers want it. The 2017 Consumer Telehealth Index survey found that in 2017, 50 million consumers would switch providers to one that offers telehealth compared to 17 million in 2017. Additionally, 60 percent of adults willing to have a video visit with a doctor want to see a doctor online regularly to help manage chronic conditions, and 20 percent of Americans would use a video visit for middle-of-the-night care.
Certain physician groups are also starting to jump on the telemedicine bandwagon. A nationwide survey of 2,016 primary care doctors found that 57 percent are willing to conduct video visits with their patients.
Telemedicine is Cost-Effective Solution for Patients and Providers
A recent UC Davis study, using data from 18 years of inpatient and outpatient telemedicine encounters, found that patients benefit greatly from reduced travel costs and time. The study reviewed data from UC Davis’ telemedicine program, which delivers specialty care through live video telemedicine consultations for patients who live in remote areas of California who don’t have access to these specialized services or would have to drive long distances to be treated. The analysis found patients avoided more than five million miles in travel distance and nine years of travel time, amounting to approximately $3 million in travel costs saved. On average, a single patient saved $156 in direct travel costs, 4 hours of time and 278 miles of driving.
Telemedicine can also be cost-effective for providers. A recent white paper from NTCA- The Rural Broadband Association, which examines the rural health care challenges and potential benefit of telehealth adoption, found rural healthcare communities could see the following savings:
- Hospital cost savings: $20,841 per medical facility, annually;
- Increased local revenues for lab work: from $9,204 to $39,882 per type of procedure, per medical facility, annually; and,
- Increased local pharmacy revenues: from $2,319 to $6,239 per medical facility annually, depending on the specific drug prescribed.
Telemedicine Isn’t Just for Hospitals
While much of the telemedicine market is catered to hospitals, these 21st century technologies can truly apply to most healthcare settings and practices. From behavioral health and primary care to public health and school-based healthcare, telemedicine’s applications are far reaching and effective for all healthcare facilities.
Telemedicine is a Tool, Not a Strategy
While the trending nature of telehealth and telemedicine has certainly led to increased adoption of the technology, many healthcare systems need to keep in mind that telehealth is simply another tool in the toolset that will be most effective when aligned to support corporate, organizational strategies. As with any tool, it’s only useful when owners know how to properly use it for their purposes. Receiving value from telehealth isn’t a result of incorporating the best technology or having the latest high-tech gadgets; rather, it relies on the healthcare systems crafting the technology to work toward advances overall organization goals. Workflow, interoperability and data gathering and sharing are just as important as which teleconferencing system you choose. In fact, the market has been noticing this trend as well. More and more companies are providing services aimed at helping organizations integrate the technologies into their own systems and workflows.
Lack of Federal Reimbursement, Coverage is a Major Impediment
If telehealth is cost-effective and leads to better patient outcomes, why isn’t it more widely adopted in the industry? One major reason is lack of federal reimbursement and coverage for these services. Healthcare providers are not being reimbursed for telehealth and remote patient monitoring, and therefore are not taking full advantage of those services, according to a new report from the U.S. Government Accountability Office (GAO). Providers surveyed for the report cited “the potential to improve or maintain quality of care as a significant factor encouraging the use of telehealth and remote patient monitoring,” but they rated “cost increases or inadequate payment and coverage restrictions” as either somewhat or very significant barriers to adoption. “Additionally, officials from another provider association described coverage as the single greatest barrier to the use of telehealth, adding that Medicare’s restrictions on the types of services covered by the program have prohibited its broader use,” the report found.
State Reimbursement Laws Need to Catch Up
Another reason why it’s difficult to deploy wide-spread telemedicine adoption is the varying laws and regulations from every state surrounding telehealth networks, including issues such as: definition of telehealth, parity laws for Medicaid reimbursement, medical licensure, online prescribing, physician-patient relationship standards and more. The Center for Connected Health Policy’s State Laws and Reimbursement Policies report is a great resource to analyze differences between all 50 states, and the American Telemedicine Association (ATA) has a State Policy Resource Center that features real-time state legislative and regulatory trackers.
There is No Telemedicine Without Broadband
Last but certainly not least, is the fundamental, critical role broadband plays in telemedicine networks. Simply put, there can be no telemedicine without robust, reliable broadband service. Video conferencing, real-time data transfers, electronic health records (EHR) and cloud-based health applications all require high-speed, high-quality connections. Rural areas are currently lagging in broadband deployment. In 2016, the Federal Communications Commission (FCC) found 39% of rural Americans—23 million people— lacked access to 25 Mbps/3 Mbps service, a speed that would make telemedicine viable. Rural areas are more difficult and more expensive to serve due to higher costs because of various factors including lower population densities, difficult terrain and fewer customers to spread costs; however, a number of small rural providers are working to make great progress on bringing high-speed broadband to rural America every day.
At TeleQuality, we pride ourselves on being one of those small providers dedicated to expanding broadband access to rural America. With funding opportunities such as the Universal Service Fund’s (USF) Rural Health Care (RHC) program, rural healthcare providers across the country can access high-speed networks and bandwidth at urban prices. We have been assisting rural healthcare providers achieve their networking and bandwidth dreams since 1999. Let us help you get your network upgraded and ready for expansion into telemedicine TODAY.