AcuteCare Telemedicine Blog


Telemedical Technology: Creating a Healthcare World without Barriers

As with many other high tech gadgetry, revolutionary processes and scientific inventions telemedicine has its roots in the NASA space program. For those early adopters of telemedicine, the efficacy of the doctor/patient consultation and the ability to improve patient outcomes were on the top of the list for barriers to entry. Many thought that patients would be hesitant to trade personal face-to-face visits with their doctor for a consultation through a virtual robot. But as early adopters used the technology to bring specialized care to remote and distant rural areas, patients soon realized the convenience and cost savings of not having to travel long distances to receive the latest in specialized healthcare, and soon embraced the new experience in connecting with a doctor.

The process is now considered to be an ideal use of technology to monitor and connect healthcare professionals with patients over long distances. With the introduction and increasing popularity of wearable technology, the existing digital info-structure in many rural areas of the country limited the expansion of telehealth. With the recent introduction of ConnectAll, a new federal initiative aimed at building broadband parity across America, is expected to provide nearly 20 million more Americans with access to telemedicine. “The expansion of affordable Broadband will further solidify the rapidly growing telemedicine sector, which is transforming the healthcare paradigm,” said Jonathan Linkous, CEO, American Telemedicine Association (ATA). “This initiative helps to deliver the promise of more cost-effective healthcare delivery models, and promotes the expansion of telehealth services for all.”

With Medicare, Medicaid, and private health insurance carriers continually expanding the number of virtual services approved for reimbursement, a once formidable obstruction is disappearing all across the country and the world. A growing number of healthcare providers are now expanding their reach. “This is a world without boundaries, and that’s what we’re seeing,” said Andrew Watson, MD, chief medical information officer for University of Pittsburgh Medical Center’s (UPMC’s) International and Commercial Services Division, “The advent of telemedicine in a world without boundaries is no different than using Facebook or Skype around the world. We’re just seeing this technology impact medicine.”

But not all of the walls to expansion have been breached. Much remains to be done to remove existing impediments such as state by state licensing and credentialing requirements. The established healthcare regulatory system with its myriad of governing bodies, Boards, and legislatures continues to be a formidable foe when it comes to interjecting new technology into the traditional face-to-face experience between the healthcare provider and patient. “In-person visits will likely remain the mainstay for local care for those fortunate enough to be around many physicians, but when minutes count in emergencies experts can step in and make the decisions that will determine a lifetime of health instead of a lifetime of disability. Telemedicine isn’t a fad but rather a disruptive innovation that flows naturally out of technological advances and has already contributed immensely to our society’s health. It’s a perfect fit for our shrinking resources,” says Matthews W. Gwynn, M.D., Partner, ACT.

ACT has been on the forefront of the use of telecommunication technology for years, remotely delivering live and interactive telestroke and other teleneurology solutions anytime, anywhere to hospitals and emergency medical centers throughout the Southeast. Progress in reforming the massive healthcare regulatory system is occurring as dedicated industry leaders tackle the challenges of integrating advanced remote medical technologies into the existing mainstream healthcare delivery model.



States are Leading the Way on Telemedicine Expansion

The states of Missouri and Kentucky are the two most recent states that are making significant strides in increased implementation and utilization of telemedicine.  Effective Jan. 1, 2014, a Missouri law (House Bill 986) makes private insurers responsible for reimbursing providers offering telehealth services just as these payers are for in-person services.  The bill states that insurers “shall not deny coverage for a health care service on the basis that the health care service is provided through telehealth if the same service would be covered if provided through face-to-face diagnosis, consultation, or treatment.”  While the new legislation benefits patients with private insurance payers, Missouri law still lacks provision for Medicaid beneficiaries.

In Kentucky, where state laws are in place for private and public payers, the legislators have expanded coverage of telemedicine services for Medicaid beneficiaries so long as these are delivered exclusively by way of interactive video-conferencing. The telehealth services covered by the law are extensive, ranging from mental health evaluations and care management to diabetes and physical therapy consultations.

These most recent events are indicative of individual state legislatures making the most aggressive progress towards removing regulations and passing legislation to accommodate the new technology’s use, while the federal government continues to focus on achieving a last place finish in the race for expansion.

American Telemedicine Association (ATA) CEO Jonathan Linkous said in a public statement recently. “The federal government places unnecessarily strict barriers and restraints on how Medicare patients are served when they deserve access to quality healthcare, regardless of geographic location and technology used.”

Kentucky and Missouri are joining a growing list of states that are realizing the benefit of telemedicine as a cost-effective delivery model for quality healthcare even though the two states have taken different approaches to expand access to telemedicine services. “This is a true win-win scenario,” said Jonathan Linkous, “First, it is a big victory for patients in Kentucky and Missouri, who now have greater access to the best-possible healthcare. It’s also a win for the treasury and taxpayers in those states, who will save significantly on public healthcare costs.”

With healthcare costs rising rapidly and access to specialized care diminishing for many Americans, it is well past a reasonable period of time for the top payer of medical services, the federal healthcare agencies and the U.S. Congress, to pick up the pace on making advances in passing and implementing legislation that will promote the advancement of telemedicine throughout the entire country.



Now is the Time

Like any other year, the beginning of 2013 brings a great deal of optimism about what surprising changes and exciting opportunities and a new year will bring, not just to healthcare, but to our everyday lives. We are living in an age of constant innovation and untamed enthusiasm for what is new. Every day, we read news about the pioneering of new solutions for age-old problems and find ourselves astonished by what we can accomplish with the collective knowledge of generations past and a zeal for moving towards the future.

Telemedicine is a prime example of an entire industry fueled by this fervor for innovation, and the resulting advances it has brought to the way we think about healthcare are nothing short of remarkable. Unfortunately, the level of investment in terms of initial costs and putting trust in new technologies has been enough of an obstacle to prevent many facilities to postpone the adoption of telemedicine.

Embracing telemedicine is about far more than flashy new technology and the promise of saving costs; it is about taking steps forward to make our world a better place. For example, the latest tragedy to make national news out of Newtown, CT served as a stark reminder that there are still great strides that need to be made in order to address the needs of individuals with psychiatric conditions. Fortunately, through telepsychiatry programs and the drastic improvements in patient monitoring capabilities afforded by telemedicine, it is easier than ever before to get help. Extending the attention and the care that is so desperately needed in cases such as these will undoubtedly help us prevent many such worst-case scenarios.

It is the hope of AcuteCare Telemedicine and other proponents of telehealth that the plethora of new equipment and methods available to providers will continue to propel healthcare towards an era in which every individual has unhindered access to the care they need. There has never been a more important time to push the many benefits of telemedicine into the spotlight, and take the first steps towards achieving this goal.