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Telemedicine Trends in 2018

By Debra Wood, contributor

Physicians and patients have both embraced telemedicine, but barriers continue to exist that thwart widespread adoption of this technology to provide clinical services to patients remotely.

“Today most people look at telemedicine through a very narrow lens of being used for low-risk healthcare: think about looking at a rash, handling a prescription, etc.,” said Sean Banerjee, chief technology officer of SOC Telemed, a national provider of telemedicine technology for hospitals and health plans.

For instance, during the recent flu outbreak, Carolinas HealthCare System in Charlotte, North Carolina, encouraged people with minor, nonlife-threatening symptoms to make use of the health system’s Virtual Visit.

Successful acute-care implementation

“It’s worth looking at the use of telemedicine in acute care, which is proven to provide real, lifesaving results,” Banerjee continued. “Telemedicine for acute care is saving people’s lives on a daily basis by providing hospital systems access to specialists 24/7 in a way that would not be possible otherwise.”

Banerjee indicated that specialists have well-established protocols for providing care that leads to positive results. Stroke care is a prime example of how telemedicine can positively affect outcomes. Multiple studies have shown its benefits in the treatment of stroke patients.

“With the example of stroke care in mind, acute telemedicine providers see so many stroke patients annually that they can drive changes to protocols much more rapidly than previously possible within health systems,” Banerjee said.

“Additionally, they can assess the effects of these updated protocols across a wide range of hospitals throughout the country. No one hospital could possibly treat the thousands of stroke patients that other telemedicine providers see every year, and with such a breadth of severity.”

An alternative to in-person visits

A survey conducted for American Well in Boston, a provider of telemedicine solutions, found that two-thirds of consumers were willing to receive care through a video visit with a physician. Video visits offer patients greater convenience.

Sixty-five percent of those surveyed said that they would like their primary care provider to offer video visits, and 20 percent said they would be willing to switch providers to one who offered virtual visits.

Many health systems are offering telemedicine visits. Carolinas HealthCare offers virtual visits 24 hours a day, seven days per week, with no appointment needed. Patients pay $49, unless the person’s employer has contracted with the health system for such visits. Patients must be located in North Carolina. Carolinas HealthCare System Urgent Care medical professionals handle the visit.

A 2018 poll by the Medical Group Management Association of nearly 1,300 medical practices found 26 percent offering telemedicine services and 15 percent planning to do so. Those not offering such services cited lack of physician buy-in, lack of need and reimbursement issues for reasons.

However, a 2017 Foley & Lardner survey of 100 senior executives at hospitals, specialty clinics and other healthcare organizations found 76 percent of those responding were offering telemedicine services or planned to in the future. More than half indicated their programs were growing.

Many organizations offering telemedicine services do so through a telehealth company.

Barriers to widespread adoption

Licensure and reimbursement remain concerns associated with telemedicine. The Center for Connected Health Policy’s fall 2017 report indicated that many states have expanded telehealth Medicaid reimbursement while others restrict such services.

In most states, the telemedicine physician or other provider must be licensed in the state where the patient is seeking treatment. A few state medical boards, including Texas and Maine, have issued special telehealth licenses or certificates. Several states have adopted the Interstate Medical Licensure Compact, which streamlines obtaining a license in participating states.

Some insurers cover telemedicine physician visits but others do not, presenting a barrier. The Foley & Lardner survey found half of the executive respondents considered third-party reimbursement the greatest implementation challenge, even though three-quarters said they received some reimbursement for the visits, but that it is typically less than in-person visit reimbursement.

The Foley & Lardner report suggested that as pressure builds to offer telemedicine services, payers will broaden their reimbursement for such services and state and federal governments will decrease regulatory barriers.

Still, telemedicine jobs for physicians remain in demand. Some are full-time positions, while many are part-time, allowing physicians to supplement their income.  

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