Written by Kathleen Roney | June 22, 2012
While both telemedicine and telehealth offer great benefits to physicians and patients, telehealth has become one of the most promising evolutions in the health care landscape. The ability to conduct remote visits with patients and monitor their recovery improves access to quality care by removing traditional barriers to healthcare delivery such as distance, mobility and time constraints.
Telemedicine has also received a lot of attention due to its similarity — and sometimes confusion — with telehealth. However, the two technological capabilities are very different. The healthcare industry has used telemedicine for around 30 to 40 years, but due to advancements in technology, not only have more hospitals and healthcare organizations and medical specialties adopted telemedicine technologies, the healthcare world has welcomed the advent of telehealth.
Telemedicine is about connecting physicians so that those in rural areas can consult with physicians based in areas that are miles away. “One of the biggest confusions is between telemedicine and telehealth. Many individuals use the terms interchangeably. Telehealth uses the same principles, but introduces the patient into the equation,” says Roy Schoenberg, president and CEO of Boston-based American Well, a telehealth company.
Here, Dr. Schoenberg and Linda Boles, chief strategist of the U.S. public sector of healthcare innovation and business development at Cisco, discuss their predictions for three future trends in telehealth.
1. Governmental support, funding will continue to increase. According to Dr. Schoenberg, the federal government, including CMS, HHS and state governments will increase funding for telehealth efforts significantly as telehealth becomes increasingly integral to reforming the U.S. healthcare system. While healthcare is generally a slow adoption market, there has been increasing momentum around telehealth on a national and state level. “The federal government moves in mysterious ways, and the last 12 months has been quite indicative of the type of support that exists,” says Dr. Schoenberg,
“This support will, no doubt, translate into continued and increased funding and legislative action.”
The activity that Dr. Schoenberg describes includes four areas where this momentum can be clearly felt:
- Defining telehealth — “There has been a flurry of activity in both the Senate and the House to come up with an expanded definition for telehealth,” says Dr. Schoenberg. Telehealth vendors, the American Telemedicine Association and the American Health Insurance Plans have been active in the discussion in order to create clarity around the scope of valid telehealth transactions, which in turn can translate into expanded utilization in programs like Medicaid and Medicare.
- Integration into ACOs — CMS has published a document explicitly stating that ACOs will be required to show meaningful use of electronic medical records and related technologies, in order to qualify for payments through incentive programs. Telehealth has the potential to play a fundamental part in making this happen. If ACOs are required to use telehealth, it will have to receive at least partial reimbursement, explains Dr. Schoenberg. “Telehealth is in CMS’ sights. It sees telehealth as an integral element of healthcare and CMS wants it to be reimbursed,” he says.
- Medicaid exemptions — According to Dr. Schoenberg, CMS has placed additional focus on telehealth reimbursement for Medicaid-States can receive a Medicaid exemption, which offers providers reimbursement even though Medicaid does not cover telehealth. The exemption allows the states who have received it to begin investing in telehealth projects.
- State legislation — In addition to the Medicaid exemption, there has been legislation at the state level requiring commercial payors to reimburse physicians for telehealth services. Fourteen states have passed bills for commercial payors to reimburse telehealth with a 15th on the immediate horizon.
2. Practice management systems will have telehealth capabilities. According to Dr. Schoenberg, leading electronic health record companies will introduce telehealth capabilities to their practice management systems, enabling online visits for thousands of physicians across the country. This will occur because the ACO model will bring great accountability to the healthcare delivery system, specifically how a physician’s ability to manage patient outcomes will affect their profit. For this reason, providers will want to increase their capability to follow up on patients, and vendors will add telehealth to practice management systems to meet the need.
“Telehealth is the simplest way for a physician to say to their patient, ‘let’s get together for a few minutes each week.’ With telehealth, the patient will not need to visit the office or schedule an appointment. Telehealth offers a close intimacy, and when telehealth becomes a part of practice management systems, it becomes part of the arsenal for physicians to take charge of their patients’ care,” says Dr. Schoenberg.
“I believe that in the future, when a physician purchases a practice management system, the telehealth capabilities will be right next to the billing, scheduling and EMR systems,” says Dr. Schoenberg.
3. Consumer demand will cause “main street” telehealth. According to Ms. Boles, the adoption rate and the use of telehealth in treating and communicating with patients is going to grow. The consumer demand is there; the healthcare industry just needs to catch up. “Consumers have a large preference for telehealth services. Some studies are even showing that there are better outcomes from telehealth than in person,” says Ms. Boles. According to Dr. Schoenberg, employers across the United States may even launch their own telehealth services for their employees, bringing telehealth to Main Street and meeting consumer demand.
There is no question that health information technology like telehealth and telemedicine are critical resources for healthcare providers, hospitals, delivery networks and newly formed ACOs In a short span of time, consumer awareness and acceptance of these technologies has risen rapidly as healthcare reform, technology and patient expectations all work to alter the way healthcare is delivered in the United States. While predictions may be made based on past trends and current initiatives, no one can ultimately guarantee how the healthcare industry will operate or look like, but there is no doubt that technology and innovation will continue to play a role in facilitating the delivery of quality care across the care spectrum.