1/9/2013 — Federal Telemedicine News
Doctor-Patient telehealth will begin to eclipse clinician-to-clinician telehealth
Background: To date, much of the action in telehealth has been within hospital systems, where telehealth connects doctors with each other in different clinical facilities. Because early telehealth systems were expensive, hardware-based systems that often required a special rolling cart and camera equipment, it wasn’t practical in most cases to connect doctors with patients in their homes.
Key trend: In 2013, software-based systems that use everyday consumer technology will make doctor-to-patient connections practical. More consumers than ever will have access to a webcam. 800 million webcams shipped in 2012, double what was shipped in 2011
Mobility takes off: The doctor will see you now – on your tablet or smartphone
Background: According to recent studies, four out of five practicing physicians use smartphones, computer tablets, and other mobile devices during the course of their workday. And more than 50% consumers now own a smartphone or Tablet. Yet mobile healthcare to date has been mostly limited to seeking information, for both doctors and patients.
Key Trend: In 2013, mobile apps will increasingly be seen as health care delivery tools. This will be a broad market involving everything from remote patient monitoring to diagnostic tools. One key area will be real-time, live video consults between doctors and patients from their smartphone or tablet. At American Well we are seeing very strong demand from health plans, employers, and delivery systems for telehealth services launching in 2013; nearly all of them request mobile applications.
Employers will emerge as major drivers of telehealth
Background: In the past, employers mainly offered nurse lines as a convenience to their busy employees and to provide them with after-hours care. While these were helpful for advice, rarely could an employee get their issue resolved in real-time with a face-to-face consultation. And no matter how helpful the advice, most employees ended up having to take time off from their busy schedules to visit the doctor during the workweek.
Key Trend: In 2012, early-adopter employers began to offer a new, more complete set of services: video access to a choice of doctors, around the clock. The drivers for this are the three “C’s” of employer telehealth:
1) Convenience – going to the doctor can take 3 hours or more during working hours – and after hours/weekends can involve going to the Emergency Room or an Urgent Care facility.
2) Complete care – in 85% of the cases, a video doctor visit results in the complete resolution of a patient’s medical issue6
3) Cost – an online doctor visit costs $35-$45, while urgent care is usually $90-$100, and the ER can cost over $1,000 a visit. 6
The National Business Group on Health/Towers Watson survey of large employers showed 23% of large employers would implement telehealth in 2013.
Telehealth will receive increased legislative support
Background: While there has been widely varying legislation with respect to telehealth, there exists an increasing momentum around the proliferation of telehealth. There are fifteen states that require private insurers to cover medical services provided via telehealth at the same rate as they cover those services for in-person visits. And today, at least 41 states offer some type of Medicaid reimbursement for services provided via telehealth. 
Key Trends: As more people enter the health insurance system, particularly through publicly-funded insurance, many legislators at the State and Federal levels will begin to see the advantages of Telehealth: expanding state reimbursement, extending the geographies in which Medicaid and Medicare beneficiaries can receive care, or supporting more telehealth pilot projects. The Veteran’s Administration has done a terrific job, for example, ending co-payments for “in-home video telehealth care” , announced plans to use telehealth to expand health care delivery to veterans living in rural areas , and demonstrated significant improvements in managing chronic care needs at lower costs . We’ll see increasing interest in making telehealth part of the publicly-funded health care provision at both the State and Federal level, and increasing public pressure to require private and public payers to support these services.
Retail pharmacies will embrace telehealth
Background: Retail pharmacies are already meeting unmet healthcare demand by becoming points of health care delivery – offering flu shots and urgent care in retail clinics. But these offerings have been mostly focused on services supplied by onsite nurse practioners.
Key trend: In 2013, large retailers will begin to experiment with bringing different types of expertise to the Retail setting via telehealth. Consumers could connect with a nutritionist to help them design a vitamin regime; or a dermatologist. During busy hours, additional pharmacists can help handle questions via telehealth kiosks/stations. And we’ll also see a critical link with employers here – as local retailers seek to help meet the growing demand for health care via telehealth-enabled clinics in the workplace.
Countdown to the Affordable Care Act – Telehealth will help the nation prepare for 1-1-14
Background: The results of the election have confirmed that the Affordable Care Act is here to stay. Now, Federal and state officials are rushing to prepare for Jan. 1, 2014 – the deadline for some of the ACA’s most comprehensive provision – health insurance exchanges and the individual mandate. Telehealth will play a critical role in delivering on these and other key provisions of the Affordable Care Act.
Key trend: The national health insurance reform legislation contains several advances for health information technologies, and telemedicine in particular. But beyond that, telehealth can simultaneously improve efficiency of an over tasked system while increasing access to consistent, high-quality care. As the nation braces for the inevitable hike in demand for medical services – we must engage telehealth technology to rewrite the map of healthcare availability around the country.
 Tech Crunch (June 2012). Face To Face: How Airtime Will Re-Humanize The Internet. Retrieved from http://techcrunch.com/2012/06/05/airtime-experience-together  The Dell Executive & Patient Survey (2010). Retrieved from http://www.healthleadersmedia.com/content/261561.pdf  InformationWeek Healthcare (Mar 2012). Global Telemedicine Market Headed For $27 Billion. Retrieved from http://www.informationweek.com/healthcare/mobile-wireless/global-telemedicine-market-headed-for-27/232602930  Jackson & Coker Industry Report Vol. 4(7) (Sept 2011). Survey: Physician Opinions of the American Medical Association. Retrieved from http://www.jacksoncoker.com/physician-career-resources/newsletters/Monthlymain/Jul/2011.aspx  Pew Research Center’s Project for Excellence in Journalism in collaboration with The Economist Group (Oct 2012). Retrieved from http://www.phonearena.com/news/Half-the-U.S.-is-now-connected-via-a-smartphone-or-tablet-mobile-penetration-booming_id35064
6 Mercer, Employer Cost Savings Study (2012). Online Care for Employers: Case Study of Health Services Company. Towers Watson (2012). Towers Watson 2012 17th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care. 2Towers Watson 2012 Onsite Health Center Survey Report.  American Telemedicine Association State Policy Center  VA Eliminates Copayment for In-Home Video Telehealth Care – May 8, 2012  Veterans in rural areas to get expanded access to health care – September 12, 2012  Care Coordination/Home Telehealth: The Systematic Implementation of Health Informatics, Home Telehealth, and Disease Management to Support the Care of Veteran Patients with Chronic Conditions. Adam Darkins, M.D. et al. Department of Veterans Affairs, Office of Care Coordination Services, Washington, D.C. Vol. 14 No. 10. December 2008.  American Telemedicine Association – “Telemedicine in the Patient Protection and Affordable Care Act (2010)”