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Telehealth: Merging of Technology and Medicine Leads to Improved Healthcare
Telehealth: Merging of Technology and Medicine Leads to Improved Healthcare
Monday, May 19, 2008http://www.progressivestates.org/dispatch
Telehealth: Merging of Technology and Medicine Leads to Improved Healthcare
States can help make health care more accessible and affordable by utilizing modern day technology. In 2007, the United States spent over $2 trillion for health care, yet consumers are still facing rising medical costs and are concerned about their access to quality medical care. Historically, health care usually involves in-person, face-to-face interaction between medical professionals and patients. In remote and isolated areas, in-person, face-to-face interactions are hindered by barriers such as distance and time constraints. These obstacles can make providing medical treatment exceptionally expensive. By merging technology and health care, however, state policymakers are creating new opportunities for medical professionals and patients to interact in more efficient ways. The use of technology in health care -- often called telehealth -- utilizes broadband applications to remotely monitor patients, facilitate collaboration between medical professionals, exchange medical data and images, and instantaneously provide efficient emergency service to remote areas. Making health care more accessible and convenient for patients and providing better quality of care to certain patients, all while reducing travel associated with medical care and providing cost savings to the health care system.
Benefits of Telehealth: Expanding Access to Health Care While Reducing Costs
The potential benefits of telehealth include increasing access to and quality of medical services, while also reducing medical costs. Although the benefits for isolated areas is especially clear, a range of patients will benefit from networking of our health care system.
Telehealth can provide rural areas or communities facing medical staff shortages with enhanced medical care and opportunities: In rural areas where it can sometimes be difficult to access medical care, especially care that requires a specialist, broadband and telehealth can connect doctors and patients via high-tech, virtual interstates. Video consultations, video collaboration and the ability to transmit high resolution images from a rural clinic to a specialist or urban medical centers can help address hardships associated with travel to see doctors for patients.
Residents of rural communities generally have less access to medical care. While traveling to a doctors visit can be a hassle or inconvenience for anyone, it is often more taxing for those living in isolated locations, patients suffering from a chronic illness, or those with disabilities. Telehealth applications, such as remote monitoring, remote consultations, and image sharing can substantially decrease the amount of travel associated with medical services. In addition, telehealth programs not only help often underfunded rural medical centers leverage the resources at better funded urban hospitals, but such programs can also help smaller clinics network with major medical centers, increasing, in certain circumstances, the ability of these clinics to offer state of the art care. Instead of driving hours to have an expert examine an X-ray or scan, a rural patient can have the necessary test done close to home and have the images sent to a doctor in any other state. The Georgia REACH Program: In Georgia, telehealth has been used to save lives and minimize the negative effects of strokes on rural citizens. The REACH(Remote Evaluation of Acute Ischemic Stroke) program uses high-speed broadband to allow doctors to examine the patient, determine the type of stroke and prescribe the correct medicine all via video conference. The telehealth program connects 10 rural hospitals with the neurology department at the Medical College of Georgia. After an individual suffers a stroke there is a short three hour time-period to diagnose if the stroke was caused by clotting or bleeding. Depending on diagnosis, the right course of treatment is instituted. Since the time it would take to transport a patient from rural Georgia to a qualified treatment center is longer than the 3-hour time-period when diagnosis must occur and treatment should be administered, previously there was little rural hospitals could do for stroke patients. Today, thanks to telehealth rural hospitals have the ability to collaborate with specialist at larger medical centers and more effectively treat stroke victims. Teleheath allows sharing of Medical Resources: Telehealth can also help communities share medical resources when shortages exist. In Maryland a handful of hospitals facing a shortage of emergency room doctors are planning on use physicians in Wilmington, Delaware to remotely monitor intensive care patients.
Telehealth can allow better management of chronic illness at a lower cost: There are estimates that more than 90 million Americans live with chronic illness and that 7 out of 10 deaths are caused by these conditions. Chronic health conditions, which often require long term care and can be difficult to treat in even well-equipped medical centers, are even more difficult to treat in rural areas where medical facilities generally have less resources to aid in diagnoses and treatment and distance may make it hard for patients to have regular check-ups. Telehealth is a tool that can help address these issues.
According to the American Telehealth Association, agencies that use remote monitoring technologies can provide home care in a more timely and targeted way than scheduled home visits would typically allow. Mechanisms,like this, that can potentially increase early interventions or assist in more routine care, are central to better symptom management, increasing patient compliance with medications and treatments, and potentially reducing the amount of time patients must spend in the hospital.
Telehealth can increase training for medical professionals: In medical facilities equipped with broadband, videoconferencing can allow medical practitioners to take part in professional development opportunities without having to travel or be too far from their patients. Telehealth has the potential to reduce health care cost: According to US Telecom, the utilization of telehealth technology has the potential to "deliver huge cost savings to America's health care system of over $300 billion annually." Aside from the cost savings associated with remote monitoring, it is estimated by the Center for Information Technology Leadership, that from "a baseline of 2.2 million patients transported each year between emergency departments at a cost of $1.39 billion in transportation costs, technologies could help avoid 850,000 transports with a cost savings of $537 million a year." For example, a recent State University of New York study found that patients using "telehealth to manage congestive heart failure experienced a reduction in overall health care costs of 41%."
Making Telehealth a RealityAlthough telehealth is not a new concept, its promises have yet to be truly realized. The obstacles to achieving the full potential of telehealth include the lack of broadband technology, the current payment structure of the American health care system, and how physicians are regulated by the government. The Need to Build-out Broadband Technology
One of the most significant barriers to large scale proliferation of telehealth has been the lack of deployment and adoption of broadband, especially high-capacity broadband, capable of supporting telehealth, particularly advanced telehealth applications. Without increased broadband deployment and commitments to expand individuals digital skills, development and adoption of telehealth technology will be slow, and the full cost savings of such technology may never be realized. The Federal Communication Commission (FCC) has recognized that broadband is a means to efficiently deliver health care services. The Commission has stated that broadband deployment in rural America one of its top priorities. Last year, the FCC announced in a press release that is had allocated "$417 million for the construction of 69 statewide and regional broadband telehealth networks in 42 states and three U.S. territories under the Rural Health Care Pilot Program." For some examples of projects funded by the Rural Health Care Pilot Programs click here.
State legislatures need to invest in broadband deployment so that their residents can start to use advanced technological applications such as telehealth.
Reforming Medical Licensing RulesCurrently, doctors who want to practice medicine in more than one state must apply for a medical license in each individual state. As of 2007, more than 35 state medical boards have restrictive licensure language in place. However, according to Stateline.org a model state law drafted by the Federation of State Medical Boards, creates reciprocal agreements among states, allowing doctors with a license in any participating state to practice in all other participating states. To date, just 10 states Alabama, California, Minnesota, Montana, Nevada, New Mexico, Ohio, Oregon, Tennessee and Texas have passed the statute, according to the Center for Telehealth and E-Health Law. A report financed by funds from the US Department of Health and Human Services, Office of the National Coordinator for Health IT (ONC) under a contract with the National Governors Association Center for Best Practices for the State Alliance for e-Health outlined models that may aid in reducing barriers to interstate practice. Some of the models outlined in the report include:
Changing Medical Reimbursement Policies
The lack of uniform and comprehensive reimbursement policies is another serious barrier to the adoption of telehealth. For telehealth technology to become an accepted part of health care practices, Medicaid must lead by example and reimburse providers for telehealth services. Once Medicaid shows public support and acceptance for the use of telehealth, private payers will be more likely to reimburse for such services. The Centers for Medicare and Medicaid Services' (CMS) web site notes that, "[m]edicaid reimbursement for services furnished through telehealth applications is available, at the state's option, as a cost-effective alternative to the more traditional ways of providing medical care." Currently, at least 35 states reimburse for telehealth services. According to a 2004 study, "at least 27 states reimbursed for telehealth through Medicaid." What services were covered by Medicaid, however, "looked different state to state":
In 2008, states continued to enact some form of telehealth medicaid reimbursement legislation, however, not every bill covered the same level of services.
ConclusionTelehealth has the ability to improve access and quality of care as well as reduce overall costs to the health care system. However, in order to see the full benefits of telehealth, there must be an increased commitment to increasing the deployment to and adoption of broadband capable of supporting telehealth applications. In order for states to be able to leverage the applications of tomorrow they must foster universal and affordable broadband strategies, as well as address licensing and Medicaid reimbursement issues. Resources Benefits of Telehealth: Expanding Access to Health Care While Reducing Costs
Latest Studies Show Consumer-Directed Solutions Like Consult A Doctor Lower Costs While Providing Greater Access to Affordable, Quality health care Center for Information Technology Leadership, The Value of Provider To Provider Telehealth Technologies
Communication Workers of America, Telemedicine Helps Save Time and Lives in Smaller Hospitals The Need to Build-out Broadband Technology
Federal Communications Commission, Announcement of FCC Telehealth Grant Recipient Programs Reforming Medical Licensing RulesInterstate Licensure of Telemedicine Practitioners
Center for Telehealth and E-Health Law--Study on state licensing policies Changing Medical Reimbursement Policies
TeleUtopia –Getting Paid for Telehealth Consultations: Summary of Medicaid Reimbursement Legislation 3 Steps Forward1. MO: Missouri Legislature Ends Session Without Passing Voter ID Amendment 2. OH: Ohio legislature approves tough payday loan cap 3. CA: California Supreme Court overturns gay marriage ban 2 Steps Back1. Nevada Transportation Board endorse Privatized Highway Toll Project 2. MS: New law in Miss. targets undocumented workers *Correction*In Thursday's Dispatch, we mistakenly characterized Iowa's HF 2645 (vetoed by the governor) as a "fair share" bill when in fact it was designed to expand the scope of public sector bargaining to allow public sector unions and management to bargain over the same things as the private sector. MastheadThe Stateside Dispatch is written and edited by:
Nathan Newman, Policy Director Please shoot us an email at dispatch@progressivestates.org if you have feedback, tips, suggestions, criticisms, or nominations for any of our sidebar features.
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