AcuteCare Telemedicine Blog


Removing Well Entrenched Impediments to Advancing Telemedicine Benefits

A recently published study in Telemedicine and e-Health found that despite numerous benefits to expanding telemedicine that there are three major barriers that remain to fully implementing the benefits of telehealth. Health care professionals agree that Telemedicine has and will continue to change care delivery and patient outcomes by expanding patient access, reducing service gaps, improving service quality, providing additional clinical support, delivering enhanced patient satisfaction and improved adherence to care standards.

Advances in powerful technology is transforming care facilitation, making real-time audiovisual communication more feasible and permitting physicians the ability to remotely consult with a patient via a robot and LCD screen.  Remote specialists and physicians can treat patients and save lives with the use of a broadband card, an internet connection from a cell phone tower and a laptop. This illustrates the amazing potential of telemedicine but the study found that serious human barriers to nationwide telemedicine still remain.

The study surveyed emergency and critical care remote presence telemedicine users from 53 healthcare institutions across North America and Ireland. One hundred-and-six surveys were completed. Sixty-eight percent of respondents were physicians, 17 percent nurses and nurse practitioners and 8 percent were administrators. The results indicated that three major human barriers for telemedicine in the areas of regulation and finance need eradication to fully implement the benefits of telemedicine.

     – Licensing for Physicians. A major benefit of telemedicine is the ability to consult remotely with physicians and patients across state boundaries, but today the current approach to medical licensing requires health providers to obtain multiple state licenses and adhere to diverse and sometimes conflicting state medical practice rules. The medical licensing process is not only complicated but also lengthy and expensive and it represents a major barrier to the expansion of telemedicine.

     – Credentialing. Credentialing can become very complicated especially for hospitals with hub and spoke models because physicians from each hospital have to have the credentials at every hospital.  The time it takes it to acquire all necessary documents and finish an application is time that could be used training medical staff to use telemedicine and bring the benefits of telemedicine to deserving patients. The current method for credentialing should be streamlined to facilitate easier credentialing at multiple facilities leading the way to wider telemedicine implementation and increased accessibility.

     – Reimbursement. A huge financial issue for telemedicine is the lack of reimbursement and capital expenditure for services. Similar to licensing issues, reimbursement models are different across the states with each having its own regulation for private payers with little or no consistency for telemedicine reimbursement.

Removing these impediments to the expansion of telemedicine remains a daunting task. Change never comes easy, particularly when it requires the cooperation of various bureaucratic agencies, multiple governing bodies and a wealth of well entrenched administrative procedures and regulations that were designed and implemented in a time when advanced communication technologies were little more than fantasy and science fiction. A continued focus on removing these barriers must intensify in order to bring the many proven benefits of telemedicine to patients throughout the country and the world.



Healthcare Reform and the Impact on Telemedicine

The recent announcement of the Supreme Court’s 5-4 ruling in favor of upholding the Patient Protection and Affordable Care Act (PPACA) has prompted widespread speculation among citizens of the US about the future of healthcare.  Notwithstanding the politics associated with the decision, the ruling carries significant impact for citizens in terms of access to preventive care and insurance coverage.

Telemedicine providers are heavily impacted by the ruling as well. The American Telemedicine Association (ATA) believes that it will positively impact the development of telemedicine, mHealth, and other remote technologies, citing 4 main reasons; the announcement reduces hesitation to invest in telemedicine technologies, protects existing investments in telemedicine, bolster’s telemedicine’s role in many healthcare programs, and strengthens telemedicine’s fundamental value proposition.

As healthcare enters its next era, telemedicine offers a model for streamlining care coordination and improving patient outcomes. In the period of time between healthcare reform being codified into law and the Supreme Court ruling to uphold it, there had been a great deal of uncertainty surrounding the healthcare industry implementing major changes in practice, as it would cause complications should the law be overturned, but the affirmation clears up many of the primary legal and cost concerns, opening the door for telemedicine to address logistical and financial pain points for both providers and patients.

Ultimately, telemedicine fits snugly into the PPACA. For ACO’s needing to include services unavailable in their area, a remote presence physician will be drastically most cost-effective than hiring a full time local MD. Telemedicine also helps alleviate costs for underinsured or completely uninsured patients as well as alleviating strain on the healthcare system caused by unnecessary emergency visits through improvements in preventive care. The court’s decision, while sparking some controversy on other fronts, is the latest step forward in the rapid evolution of telemedicine as a powerful solution for a multitude of healthcare issues facing Americans.