Telemedicine’s Time Has Come!

Sutherland Editorial

The noise surrounding recent failed attempts to repeal and replace the Affordable Care Act obscured bipartisan legislation introduced the same week in an attempt to expand the use of telemedicine as a means to reducing costs.

Medicare strictly limits the forms of telemedicine it will currently reimburse. The Evidence-Based Telehealth Expansion Act of 2017 would waive many of the restrictions, including geographic limitations, and restrictions on the use of store-and-forward technologies that package and transfer images and files to a clinician, who responds with a diagnosis and treatment recommendations. The bill specifies that to be granted a waiver the telemedicine application must reduce spending without reducing the quality of care.

Despite its bipartisan authorship and the common sense underlying it, the legislation appears to stand little chance of success, raising questions about when health policy and regulation will catch up with the fast-developing state of digital health and telemedicine.

Current telemedicine practice can be divided into three sectors. The first is provider-to-provider, where healthcare institutions provide remote consults, enabling highly specialized care across a wide geographic area in time critical care scenarios.

The second sector is remote patient monitoring, offering the possibility of managing conditions such as diabetes and hypertension in a proactive way, and a market that research firm Berg Insight estimates will exceed 50 million patients in the next four years.

The third segment, patient-to-provider, relies upon peoples’ increasing comfort level with technology intended to make their lives easier, which they now want to see extended to healthcare. They now expect to be able to make appointments, pay bills, and access their medical information online, as and when it suits them!

And it’s not just millennials who feel this way. A 2015 Mayo Clinic study showed nearly two-thirds of older urologic patients were “very” or “somewhat likely” to book a video visit with their provider. Those that do try telemedicine like it, with video interactions typically getting 80 percent-plus approval ratings.

The technology is not the issue here. While there is still work to be done on integrating various platforms, it’s consumer acceptance and adoption that will drive the telemedicine development bus. Physicians, trained in a culture of person-to-person care, will have no choice but to overcome their misgivings and embrace the convenience and cost reductions offered by telemedicine.

And, somewhere along the way, politicians will have to figure out the value of telemedicine, and provide the legislative and regulatory framework that will allow it to fulfill its true potential to deliver high-quality, value-based care.