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Telemedicine has been a medical buzzword for several years, and the variety and depth of services provided has grown dramatically during this time. While generally partnered with “rural health”, telemedicine is becoming an integral part of general health services in all population areas. Part of the reason for this is due to the wide scope of services that encompass the term. Ask five different people what telemedicine is and you are likely to get five different answers – all of them correct. The World Health Organization defines telemedicine as the use of “remote transmission of video, audio, and text data to provide information to individuals involved in a patient’s care.” In general, it is the provision of healthcare consultation and education using telecommunication networks to transfer information. Under those guidelines, telemedicine includes such services as: specialist referral services, patient consultations, remote patient monitoring, telephone nurse triage, and medical and health information and education. While the types of telehealth services are numerous and continuing to expand, there are key barriers that have slowed its advancement.
In spite of the fact that telecommunication was first used by the National Institute of Mental Health in the 1950s, and NASA monitored the health of astronauts in space using telemedicine in the 1960s, we are still working to address some of the same barriers today that were present fifty years ago.
- Broadband Access. As many of the services offered through telemedicine require high-speed Internet, healthcare providers in rural areas and/or low-income patients do not have the access needed to receive many of the telehealth services available.
- Legal Issues. Provider reimbursement, malpractice liability, and multistate licensure need to be addressed before telemedicine can be fully utilized as needed. Currently, there are several bills and discussions occurring in Congress to help address these concerns, but progress is not being made fast enough.
- Provider and Patient Comfort with Technology. If healthcare professionals are not properly trained and comfortable with the technology, and/or if patients do not feel it offers helpful, quality care, telemedicine options will be overlooked and even avoided.
There is progress being made in all of these areas, but the longer it takes to resolve these issues, the fewer health and life-saving services provided through telemedicine.
Additionally, while not a major barrier, HIPAA compliancy is an issue that must be considered and appropriately managed in order to expand telehealth options. Providers must take caution when selecting telemedicine options as most email, text messaging, and other formats do not follow HIPAA requirements. (see related article on secured texting: http://triagelogic.com/Smart-Phones)
BENEFITS OF TELEMEDICINE
Numerous studies have demonstrated how telemedicine can improve patient access to healthcare while increasing the quality of care provided in a cost-effective manor. However, these benefits deserve more attention due to the cumulative impact delivered.
- Addressing the Shortage of Primary Care Providers in Rural Areas. Telemedicine provides a means of serving rural areas, and thereby increasing the health of more than 25% of the population.
- Reduced Patient Travel. When patients do not have to travel long distances to receive care, they are more likely to get regular physicals and utilize available health services before the situation becomes a medical crisis.
- Improved Triage. Telemedical triage has been shown to reduce unnecessary emergency room visits, while also increasing the use of medical services during emergency and/or life-threatening situations.
- Increased Quality of Care. Studies indicate that patients are reporting a higher rate of satisfaction with patient-physician communication during telemedicine consults compared to in-person visits.
- Provider Efficiency. Through telemedicine, mid-level practitioners are able to provide care under the supervision of physicians. This helps increase the efficiency of the physicians’ time, while maintaining quality patient care.
- Cost Effectiveness. Many studies are showing that telemedicine is a cost-effective means of providing health services. One example is an e-ICU service in South Dakota that saved eight hospitals over $1.2 million in patient transfer costs over just 30 months.
HERE TO STAY
Whether it’s videoconferencing, telephone triage, remote patient monitoring, or remote surgeries – telemedicine is here to stay. The benefits to patients, providers, and the healthcare system as a whole are too significant to ignore. Furthermore, as technology continues to advance, telehealth options will, too, which will allow healthcare professionals to provide more services to more people with less difficulty.
Have you considered providing telemedicine in your practice? If so what was your experience? What was your patient feedback? Share them with us in the comments section below or in our social media sites.
Frederick, S. (2013) The Keys to making telemedicine work. Health Management Technology. Retrieved August 20, 2013 from: http://www.healthmgttech.com/articles/201304/the-key-to-making-telemedicine-work.php
Harding, A. (2013) Telemedicine improves care for kids seen in rural ERs. Reuters Online. Retrieved August 20, 2013 from: http://www.reuters.com/article/2013/08/19/us-telemedicine-kids-idUSBRE97I0VK20130819
LeVert, D. (2010). Telemedicine: Revamping Quality Healthcare in Rural America. Retrieved August 20, 2013 from http://luc.edu/media/lucedu/law/centers/healthlaw/pdfs/advancedirective/pdfs/issue4/levert.pdf