Fran Turisco, Research Principal in the Global Institute of Emerging Healthcare Practices at CSC
Voxiva and ViTelCare are among the many companies in the Washington area and around the globe that have developed telemedicine solutions through online and mobile technologies. Telemedicine is considered to be a key technology enabler of U.S. health reform efforts as it has proven in numerous pilot efforts to contain medical costs while improving access and quality.
Instead of taking off work to make a face-to-face visit, patients through telemedicine can send e-mails regarding minor health issues or medical questions and use webcams for online visits. For physicians, online communication offers a unique way to control their schedule and optimize productivity.
Still, there are roadblocks to moving this technology forward: Often the regulations governing the processes are well behind the innovations. Progress is slowly being made but there are several ways the federal government as well as states can help put telemedicine in the fast lane:
Telemedicine technology allows patients to confer with physicians anywhere around the country. But licensing requirements limit physicians’ jurisdictions.
Overcoming unnecessary licensing barriers is the best way to expedite professional mobility. Cross-state licensing “is seen as one element in the panoply of strategies needed to improve access to quality care services through the deployment of telehealth and other electronic practice services,” according to a recent report issued to Congress by the Health Resources and Services Administration, a U.S. Department of Health and Human Services agency that seeks to improve access to health care services for the uninsured. The agency has awarded grants to the Federation of State Medical Boards to promote physician license portability, encouraging states to set criteria allowing them to approve a valid license of another state.
To date, eight states have adopted the process. More need to do so.
Another problem is reimbursement for services. Not all payers reimburse for telemedicine services, and those that do have restrictions that prohibit telemedicine as a solution for widespread use. For example, waivers are needed to remove restrictions in Medicare Part A and B, to expand the types of locations for telemedicine such as a patient’s home, to include care for patients living in metropolitan areas and for a broader range of services such as physical therapy, occupational therapy and speech therapy.
Physician credentialing is another issue that has hindered telemedicine. The current process requires hospitals receiving the telemedicine services to credential the physicians from the sending hospital — an extremely burdensome task. However, the Centers for Medicare and Medicaid Services recently released a final rule to streamline the credentialing process which should help.
Telemedicine leads to higher workplace productivity, reduced health care costs and less strain on care providers. Patients and the medical community understand the benefits of telemedicine. While progress is being made, the government needs to ensure that legal and regulatory changes are made so telemedicine can truly be a key component of health reform in the United States.
Originally published in the Washington Post, May 8
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