One of the fastest growing trends in health care in recent years is telehealth. Telehealth is touted as a means to improve access to care for patients who live in rural areas, as well as a convenient alternative for homebound patients or those living with chronic diseases. Rather than making regular trips to the doctor’s office, patients who only need to check in or ask a question can meet with their provider via video chat instead.
Proponents of telehealth promote the convenience and cost savings as major benefit, but the concept still hasn’t achieved wide acceptance. Government leaders and health providers are trying to change that, though, and it’s likely that telehealth will soon be an integral part of health care delivery in the U.S.
What’s Holding Telehealth Back?
Telehealth, in certain forms, has actually been used for over a decade. For example, hospital radiology departments have long relied on radiologists working remotely to read films during periods of high volume or during hours when staff isn’t available. In other cases, rural emergency departments have connected with providers in larger hospitals to provide expertise and guidance in specific trauma cases. However, for the most part, telehealth services have been limited primarily to doctors working with other doctors.
That is, until recently. In some states, patients can connect with their physicians for minor illnesses (like suspected strep throat) or for follow-ups on chronic disease. Even the mental health industry has gotten in on the act, with patients “seeing” their therapists online. Several smartphone apps and online services are available to manage telehealth, and home health software that allows providers to manage their caseloads is becoming the norm, but several barriers have kept it from wide acceptance, including:
- Issues with physician credentialing. Not all states allow physicians to use telehealth, and for those services offered via app, providers may not be licensed in all states.
- Differences in state laws. Not only do physicians need to be licensed in each state to practice, but also they must adhere to the laws governing the practice of medicine in that state. This creates issues for a smooth use of telehealth across state lines. For example, Texas laws require physicians to see a patient in person before they can employ telehealth, thereby preventing physician in that state from connecting with individuals who might only need a single visit for a minor illness.
- Technological problems. Broadband Internet connectivity isn’t available or up-to-speed in all parts of the country, effectively preventing the very people who could benefit the most from telehealth — those in rural areas — from even accessing it.
- Reimbursement issues. Currently, Medicare does not reimburse physicians for telehealth services, although several bills are under consideration.
- Concerns about patient privacy.
While these issues are still being addressed by regulators and telehealth providers, there are signs that widespread telehealth adoption will soon become a reality.
Telehealth Enhancement Act of 2015
One major step toward the wider acceptance of telehealth is the Telehealth Enhancement Act of 2015. This proposed bill removes many of the barriers to telehealth, including:
- Reimbursing providers for telehealth services
- Changing FCC rules to allow providers to offer services from anywhere, and to enhance provider access to advanced telecommunications
- Including telehealth as a benefit in Medicare Advantage plans
One of the major goals of this act to reduce hospital readmissions, and experts see telehealth as one way to keep patients from returning to the hospital after they’ve been discharged. Not only can providers identify possible issues before they occur, but it’s more likely that patients will adhere to discharge instructions when they can meet with a provider remotely.
Another piece of legislation that has the potential to expand telehealth is the Federation of State Medical Boards Compact Act, which, if passed, essentially gives doctors in participating states reciprocal licenses. This effectively removes the barriers to doctors only being able to practice in a single state, and allows patients to see doctors no matter where they happen to live. Of course, this act does not address issues of reimbursement and privacy, but supporters of telehealth see it as a step in the right direction.
In a recent study by the Mayo Clinic, 66 percent of the respondents said that they were willing to see a doctor via video chat. Clearly, patients are in favor of using technology to improve their access to health care, so it’s only a matter of time before the barriers to adoption are lifted. Expect new laws, and changes to existing laws, to make telehealth a reality — and make it easier to get the care you need.