Telemedicine is the use of medical information exchanged from one site to another through electronic communications to provide consultations, monitoring, diagnoses and other medical treatment to a patient. Videoconferencing, transmission of still images, patient portals, and remote monitoring of health vitals, continuing medical education and nursing call centers fall under the umbrella of telemedicine.
Telemedicine has been used for over 40 years for providing greater access to healthcare services in rural areas but recently; there has been exponential growth in the use of telemedicine. This is partially attributed to the Patient Protection and Affordable Care Act (PPACA) promoting telemedicine as an option for improving access to care and as a way to address the need of the increasing number of newly insured patients. The Center for Medicare and Medicaid Innovation (CMI) has also begun to test new models of care using telemedicine to improve care quality with TeleHealth services and remote patient monitoring being considered as ways to support the ACO model and promote patient engagement.
There are approximately 200 telemedicine networks in the US, connecting 2,000 medical facilities with about half of these networks providing patient care services daily. Telemedicine brings access and convenience to patients, particularly those in rural locations. This allows for quicker and more accurate diagnoses, reduced ER visits and hospitalizations and better post-discharge care. Telemedicine has the potential to reduce the overall cost of healthcare services through more efficient management of chronic disease, shared staffing, reduced travel time and less frequent hospitalizations/readmissions.
Telemedicine services that lead to direct cost savings:
- Specialist referral services
Patient data is reviewed remotely by a specialist who then provides the patient with a consultation via live video conferencing. Sending patient data to be reviewed remotely enables healthcare physicians to work as a pooled resource, improving accessibility for locations that otherwise would not have these services and reducing underutilized provider time.
- Remote patient monitoring
Remote monitoring of patient’s health vitals can be used to supplement home services and also reduce utilization of costly of inpatient care. Monitoring vitals reduces the risk of hospital readmission or ER visits by handling conditions before they escalate and become a crisis.
- Telemedicine networked programs
Telemedicine networked programs provide specialty care to rural hospitals, small clinics and allow for at home triage. Patients and providers save travel costs and time. This also allows for smaller facilities to offer more specialized services that would otherwise not be available. Networked programs also allow for home triage services that can lead to reduced ER visits.
While telemedicine has the potential to provide greater accessibility to care, boost efficiency and reduce costs, there are also several challenges associated with it. In regards to provider/facility reimbursement, a distinction has not been made between services provided on site and services provided through telemedicine. Patient satisfaction can also be an issue with some patients feeling that telemedicine depersonalizes their care. Experts also worry of the cost of providing these services, the level of IT infrastructure required and the learning curve of healthcare professionals using the technology. Telemedicine also presents the possibility for a myriad of state-specific provider licensure issues that need to be addressed. Educating providers, facilities and patients on the technology, use and benefits of telemedicine is the first step to realizing the full potential that telemedicine has to offer.