8- TELEMEDECINE & TELEHEALTH by PHARMAGEEK

Telemedicine is one of the most notable advancements making waves in the digital transformation of healthcare. Telemedicine poses wins for healthcare organizations seeking to improve patient access while controlling costs, as well as healthcare consumers looking for more convenient ways to engage with providers.

 

With 71 percent of providers reporting the use of telehealthand telemedicine tools, it’s clear that the industry is sold on the benefits of virtualized care. Telemedicine market projectionssuggest that the industry will reach roughly $20 billion by 2025.

 

The patient and provider benefits of telemedicine are manifold—including reduced readmissions through remote patient monitoring, reduced costs via virtual access to specialists, and improved patient engagement—but barriers to adoption still linger. Here are five key challenges giving healthcare executives pause when it comes to telemedicine adoption and recommendations on how to successfully navigate those hurdles.

 

1) Understanding what comprises telemedicine. Due to varying state and federal definitions, as well as variance between Medicare, Medicaid, and commercial payer guidelines on what constitutes telemedicine, confusion still exists regarding what services will and won’t be reimbursed. Establishing a keen understanding of what virtual services qualify and how those services are reimbursed for each payer is vital. This will lay the foundation for quantifying the potential revenue impact of adoption.

 

2) Concerns around the cost to implement. Costs associated with telemedicine program adoption can include a myriad of factors, from video conferencing adoption to remote patient monitoring expansion. To mitigate the potential for expense sprawl, executives should identify key, phase-one telemedicine service offerings. Weigh earnings potential against anticipated program implementation and support costs to justify those telemedicine coverage areas.

 

3) Added data vulnerability. With healthcare security breaches on the rise, executive teams remain cautious of any patient data exposure risk. Many view virtual care delivery as an additional layer of potential threat. As with other IT implementations, thorough security protocols and routine audits should be put in place to guard against the real-time exposure of protected health information (PHI).

 

4) Potential for fraud and abuse. Telemedicine agreements can be subject to federal kickback laws, particularly in situations involving referrals for additional services. Providers must remain up-to-date on the regulations governing telemedicine services to ensure regulatory compliance and proper eligibility for reimbursement.

 

5) Patient awareness of and trust in virtual care offerings. Even with the proper broadband and internet resources in place to support patient adoption of telemedicine, providers may encounter patient reluctance to engage virtually. Healthcare organizations must cultivate trust by educating patients on offerings and what they can anticipate during virtual visits. Providers should also address security concerns with patients.

 

To ensure that engagement in telemedicine is a long-term trend as opposed to a short-term fad, healthcare providers will have to address and overcome these challenges. By implementing a telemedicine strategy that addresses these challenges head-on, providers can overcome barriers and rise to meet growing consumer demand for more convenient provider engagement options. As more healthcare organizations pivot to embrace new digital health platforms, telemedicine adoption, specifically, is quickly emerging as a key differentiator in an increasingly competitive landscape.

Telehealth has emerged as a critical tool in providing health care services. [1] The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.

 

The Changing Face of Telehealth Law
Today’s competitive health care marketplace has created an environment where patients demand lower costs, higher service quality, and convenient access to services. [2] Telehealth is an innovative and valuable mechanism that provides patients with efficient access to quality services. Lowering costs and removing barriers to service access, are critical components in promoting patient wellness and population health. Convenience and cost-effectiveness are important commodities in the modern health care marketplace, as patients tend to avoid treatment that is difficult to access or too expensive. As a result, telehealth technology is emerging as a preferred choice among patients and providers. Telehealth has also attracted the attention of US legislators. They utilize this tool for improving the competitiveness of American health care services. This is especially important, seeing as health care represents 17 percent of the nation’s gross domestic product (GDP). In fact, the resource has helped to define the role that lawmakers play in ensuring that patients benefit in a competitive health care market.

 

Reimbursement for Services Delivered by Telehealth
The laws regarding reimbursements change regularly as more service providers incorporate telehealth technology into their practices. Reimbursement procedures can vary by state, practice, insurer, and service. [3] Care providers need to understand several facts, regulations, and laws to navigate Medicare telehealth reimbursements. They must first scrutinize whether the distance between the facility (the originating site) and the patient is far enough to qualify as a distant site. The location must also qualify as a Health Professional Shortage Area (HPSA) per Medicare guidelines. Additionally, the originating site must fall under Medicare’s classification as a legally authorized private practice, hospital, or critical access hospital (CAH). For instance, the Centers for Medicare and Medicaid Services ranks the Harvard Street Neighborhood Health Center as a top facility in need of physician services based on these criteria. Care providers must also use proper insurance coding to be reimbursed for hosting services that use telehealth technologies. For now, collecting reimbursements for telehealth services remains simpler for practitioners who limit the scope to which they apply the technology.

 

Telehealth or Telemedicine?
The term ‘telehealth’ is gaining popularity among medical professionals, compared to the original term, ‘telemedicine.’ [4] Some medical professionals use the names interchangeably. However, telemedicine is a term that may apply to the application of any technology in the clinical setting, while telehealth more distinctly describes the delivery of services to patients. Telemedicine is a familiar term, but telehealth more appropriately describes the latest trends in using technology to deliver treatments to patients. Depending on the organization, service providers may use a different definitions of telehealth. Although the basic premise remains similar, the context may change according to factors such as organizational objectives, and the needs of the patient population being served. Medical experts do agree on one point; telehealth is an innovative way of engaging patients, and it is highly beneficial for both providers and patients.

 

The Road Ahead
There are several areas where telehealth medicine could make a significant impact. It could be used as a tool to remotely monitor patients who have recently been discharged. It may also help treat individuals with behavioral health issues who might normally avoid treatment due to its high cost, or to avoid any perceived public stigma. [5] The largest area where technology could advance medicine is in treating the chronically ill. These patients usually require many visits with several specialists who may practice at different and distant originating sites. To move telehealth forward, organizational leaders must present evidence to peers and patients that the technology offers value. In addition, care providers must work to transition patients from using telehealth services only for minor conditions (for headaches, colds, etc.), to accepting the technology as a viable replacement for costly physician office visits. Advocates for telehealth medicine must also develop quality controls, so that this potentially transformational tool can maximize its problem solving capabilities and its service effectiveness. To harness the benefits of telehealth technology, America’s brightest medical professionals (both experienced and up-and-coming) must make a concerted effort to incorporate the tool into their practices and make it a regular service offering. Today’s medical students — as they enter a world where telehealth is becoming more pervasive — can take part in what might be a monumental change in the way health professionals think about medical treatment.