In an age when technology disrupts one industry after another, it may be helpful to spend some time thinking about technology and healthcare. Specifically, let’s focus on telemedicine – including telehealth (using electronic communication media to provide clinical services) and remote patient monitoring (using technology to monitor patients with certain chronic conditions).
Telemedicine holds great potential:
- For individuals who cannot travel or live in remote areas, telehealth can provide critical evaluation and condition management support and can be used to provide certain clinical services directly, such as psychotherapy.
- Telemedicine allows medical facilities in remote areas access to specialists and other resources.
- Remote monitoring holds tremendous promise in monitoring certain chronic conditions, such as cardiovascular and respiratory disease and in improving mortality and quality of life while reducing hospital readmissions.
- The average cost of a telemedicine visit is less than half the cost of an in-person visit and studies have shown that for acute care needs patient issues are generally resolved on the first telemedicine visit.
And the statistics indicate that telemedicine is in the midst of a real boom. Reports showing double digit annual growth abound. For example, one provider of telemedicine services reported a 65 percent increase in the number of visits from 2015 to 2016. Similarly, it has been projected that 90 percent of large employers will offer telemedicine by 2018.
But, in order for telemedicine to realize its potential and really reduce health care costs and improve outcomes, there are a few obstacles that need to be addressed. These obstacles are not technological but, rather, are human.
The Federal Government. The federal government is the largest purchaser of healthcare in the U.S., accounting for almost 30 percent of national healthcare expenditures. And, the federal government has been slow to embrace telemedicine; for example, Medicare places significant limits on how and when telemedicine will be covered. The federal government is not opposed to telemedicine. Rather, as discussed in a recent report from the Government Accountability Office, the feds want to make sure that telemedicine is used only where proven effective, that it is used in a way that reduces costs rather than simply increasing utilization, and that an appropriate approach for reimbursing telemedicine is developed.
State Regulators. The states, who are responsible for regulating the practice of medicine, continue to grapple with telemedicine. For example, Texas still prohibits the use of telemedicine unless a face-to-face meeting between a physician and a patient before the physician can use telemedicine. And, the ability to practice telemedicine across state lines is still limited by state licensing requirements.
Some Hopeful Signs
These institutional barriers are eroding; both the federal government and states continue to open the doors to the greater use of telemedicine. A proposed law in Texas to ease restrictions on telemedicine seems headed for passage and states are considering new rules that would allow doctors and nurses licensed in one state to practice telemedicine in multiple states. And both Congress and federal regulators are weighing new rules to increase access to telemedicine.
So many approaches to reducing health care costs simply shift – but do not truly reduce – costs. Perhaps telemedicine will provide a way to really reduce costs while improving health outcomes.