Is a strategy that’s been in practice for at least two decades really innovative?
Telemedicine has been a bit of a tortoise among health information technologies, making its way slowly into practice since the 1990s. But some think the industry is past the tipping point.
As an encouraging sign, participants on Converge’s telemedicine panel offered evidence that it’s being increasingly seen as a valuable tool for healthcare providers.
Julie Hall Barrow, senior director of healthcare innovation telemedicine at Dallas Children’s Medical Center, said she helped implement tele-stroke therapy in four dozen hospitals across the state of Texas. And Gary Capistrant, executive director of policy at the American Telemedicine Association, pointed out that the American Medical Association recently adopted a set of standards to ensure appropriate coverage of telemedicine and encourage innovative use of it.
But that long, slow journey isn’t over yet.
Kenyon Crowley, deputy director at University of Maryland’s Center for Health Information and Decision Systems, said that although technology exists to facilitate virtual visits and mobile health monitoring, that technology has yet to become a seamless part of providing and documenting care.
“We’re getting so much data in the system, and physicians don’t quite know what to do with that data or how to be responsible for it,” he said. “But as we get better at that transition of data from home devices to clinical systems […] while putting on top of that some kind of interface layer that just presents the data that the decision-makers and patients need at the right time, that will help too.”
Barrow said Children’s experienced that pain point when it released a mobile tool for cystic fibrosis patients. “We had all the clinicians at the table and all these data points that I thought would be great, but they were like – stop; we only have so long with that patient and I only want these three things,” she explained.
Then there’s the policy side, where reimbursement and licensure issues still inhibit full implementation of telemedicine, Capistrant said. Many payers still include what he called “artificial distinctions” in their coverage of telemedicine, like covering only patients in rural areas.
“There’s lots of artificial barriers that create an unproductive and unlevel playing field between in-person care and telehealth” he said.
Meanwhile, varying licensure and practice rules across states prohibit doctors from providing care to patients in different parts of the country, despite the technology that exists to do so.
But now that telemedicine has captured the attention of big healthcare players and policymakers, progress is sure to come.
“There is kind of a knee-jerk resistance to change with some, but other medical specialties are very far along,” Capistrant said. “You’ve got some localities that are very far along in not just using telehealth as a substitute for an in-person visit, but really using it in a way to transform the healthcare delivery system and making it the first thing you use, not the last.”