How is Telemedicine Transforming Health Care

The improvement of technology is greatly benefiting the telehealth market. Faster internet speeds, changing insurance standards, smartphone advancements, and increased numbers of health care providers using telehealth services, are all working together to change the future of telehealth.

Telemedicine services and technologies open the door for higher quality health care in remote locations. Doctors Without Borders is utilizing telemedicine services upwards of 10 times a day to relay medical questions about specific cases to their growing network of experts around the world, simply using the internet.

Mercy hospital systems, Virtual Care Center’s, provides remote support for intensive-care units, emergency rooms, and additional programs to 38 smaller hospitals from Oklahoma to North Carolina; many of these sites are without a physician on-site 24/7. Critical-care doctors using TeleICU, are able to sit at oversized video monitors and monitor data on ICU patients. Technology allows for physicians on the other side of the camera to even zoom in to the tiny print of an IV bag.

“It’s almost like being at the bedside—I can’t shock a patient [restart his heart with electrical paddles], but I can give an order to the nurses there,” says Vinaya Sermadevi, a critical-care specialist.

These monitoring systems are delivering positive results. ICUs monitored by Mercy specialists have seen a 35% decrease in patients’ average length of stay and 30% fewer deaths than anticipated. “That translates to 1,000 people who were expected to die who got to go home instead,” says Randy Moore, president of Mercy Virtual.

Although the numbers are positive, telemedicine still has a ways to go. In a recent study performed by HealthMine, 39% of respondents had never heard of telemedicine with 42% stating they preferred an in-person doctor visit. Rules and regulations surrounding telemedicine continue to change and vary widely state to state. Standard of care guidelines are still in process of being finalized as more and more physicians get on board.

Telemedicine’s future will depend on how—and whether—regulators, providers, payers and patients can address these challenges facing the future of telemedicine. Some questions still remain:

  1. Do patients trade quality for convenience? Critics of telemedicine worry convenient, at-home type services sacrifice quality of care. Consulting a random doctor patients will never meet, they say, further fragments the health-care system, and even minor issues such as upper respiratory infections can’t be thoroughly evaluated by a doctor who can’t listen to your heart, culture your throat or feel your swollen glands. Recently, the American Medical Association approved new ethical guidelines for telemedicine, calling for participating doctors to recognize the limitations of such services and ensure that they have sufficient information to make clinical recommendations.
  2. Who pays for the services? Insurers are hesitant to provide coverage for telemedicine services, such as phone, email, or video consultations for existing patients. Some 32 states have passed “parity” laws requiring private insurers to reimburse doctors for services delivered remotely if the same service would be covered in person, though not necessarily at the same rate or frequency. Reimbursement gaps and variations continue to plague the growth of telemedicine service offerings.
  3. Is the state-by-state regulatory system outdated? The job of regulating medicine has been previously left to the states, but some question whether this creates more problems with so many varying rules and regulations. Today, doctors must have a valid license in the state where the patient is located to provide medical care, which means virtual-visit companies can match users only with locally licensed clinicians. 17 states have joined a compact allowing a doctor licensed in one member state to quickly obtain a license in another. While welcoming the move, some telemedicine proponents would prefer states to automatically honor one another’s licenses.
  4. What counts as practicing medicine? The exact definition of “practicing medicine” varies from state-to-state. A growing number of companies are classifying the diagnosis of anonymous conditions as simply providing information, not medical advice. Since no patient-physician has been established, these companies believe the information does not fall under “practicing medicine”.
  5. How will this change competition? Telemedicine is changing the healthcare market. Insurance companies are creating their own virtual doctor visit services. Major health systems are making their physicians available for virtual follow-ups to new and existing patients. Johns Hopkins Medicine, Stanford Medical Center, Harvard-affiliated Partners HealthCare and other academic centers are all offering remote consultation services.

Answers to these questions will continue to unfold over time. For more information on how telemedicine is changing the face of health care, click here for the full article by the Wall Street Journal.


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