With the recent push to achieve “meaningful use” of EHR, the advent of Accountable Care Organizations, increasing numbers of patients, and other effects of the Accountable Care Act telemedicine is becoming more common and more necessary than ever. But what is telemedicine exactly? The American Telemedicine Association defines it as follows:
“The use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.”
But telemedicine has been around in one form or another for decades. Why is it suddenly so relevant? Why are nearly half of respondents in a recent poll reporting that they now use multiple forms of telemedicine? There are several answers to this question, but two in particular stand out. First, telemedicine integrates naturally with other technology that is being widely implemented either by legislative mandate or otherwise. Second, telemedicine provides effective and efficient means for practices to adapt to the changes that the Affordable Care Act is bringing to healthcare.
In terms of integration, the obvious example is electronic health records (EHR). Nearly all practices have begun making the transition to EHR, or if they haven’t, they will be within the next year or two. The use of EHR is now mandated, and not complying will bring fines and loss of revenue. And once a practice moves to EHR, telemedicine becomes much more of a natural next step than ever before. For instance, as we have discussed here before, patient portals are a common way of integrating EHR into patient care. Well, patient portal technology often includes options that allow for telemedicine such as encrypted messaging and file sharing—the ability to share images is an important part of telemedicine—and even two way video. As HIMSS Director of Research Brendan FitzGerald said recently in an interview, “Having different solutions integrated and the ability to seamlessly connect physicians to patients, physicians to other physicians and organizations to other organizations, the electronic health record [EHR] is seen as somewhat of the hub of being able to do that within an organization.” So that is one key factor driving the increasing adoption of telemedicine.
The other though is important as well. As I hinted at above, there are numerous parts of and results of the Affordable Care Act that serve to make telemedicine beneficial and a more valuable option. Consider the sheer number of patients being added to the healthcare system over the next few years. With an estimated 30 million eventually to receive insurance, and an average twenty day wait time to see a doctor already according to some estimates something has to give. For many reasons it seems unlikely that the number of physicians is going to skyrocket, so telemedicine becomes an attractive option. Doctors, can see many more patients using two way video than through traditional office visits, particularly for non-serious medical issues like colds and sinus infections.
Additionally, as ACOs and other non-traditional structuring options for networks of healthcare providers become more common telemedicine, along with EHR becomes a natural area to explore. The same technology that allows doctors to have a virtual appointment with a patient also allows them to connect securely and in a HIPAA compliant way with other physicians, specialists, and healthcare employees. In other words, the technology being used in telemedicine isn’t limited to single use applications. Things like encrypted text and image sharing technology, secure two-way video communication, and even video conferencing have many potential applications, especially for doctors who may work in different physical locations, but are part of a network or group of some type that requires regular communication among doctors and service employees.
Of course there are other reasons for adopting telemedicine. It has seen some use for many years because of its utility in serving those in rural areas or with limited access to local healthcare. And as technology develops and becomes more reliable, less expensive, more mobile, and more flexible we will see more of this type of use. Indeed, it can be truly inspiring to consider what some of the technology being developed and improved today might be able to do in terms of providing healthcare to traditionally underserved populations.
But the widespread adoption of other technology and the shifts in the healthcare world that are coming about as a result of legislation and changes in the market are what make telemedicine likely to take off in unprecedented ways over the next decade or so. There will be challenges, and telemedicine will of course never make traditional doctors redundant, but it does have a place. Telemedicine will allow practices to fill gaps, treat more patients, improve efficiency, and probably even save some cost in the long run.
This post was written by Justin Donathan.
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