"Reimbursements" is the operative word. Of the 22 telemedicine technologies Gartner identified, lack of reimbursement is an adoption hurdle for at least seven-including some, such as home health monitoring and remote video consultations, which have a "high" benefit for healthcare organizations. (Without reimbursements, physician will just stick to office visits, for which they are reimbursed.) Licensing is another issue, as many physicians are licensed to practice in states that won't let them practice telemedicine across state lines.
Legislation Aims to Remove Telemedicine's Bureaucratic Barriers
That's where Rep. Thompson's bill, the Telehealth Promotion Act of 2012, comes into play. (The bill was introduced in the waning days of the 112th Congress, which ended January 3, 2013, and must therefore be reintroduced this year. It also refers to telehealth, an umbrella term that encompasses telemedicine, the use of technology in the practice of medicine, as well as more academic and research-oriented uses of technology in healthcare.) Linkous says the bill is attracting the support of both political parties-and, judging from what he heard at the Consumer Electronics Show, technology executives as well.
Among other proposals, the bill would no longer exclude from federal reimbursement medical services "furnished via a telecommunications system." In addition, physicians licensed in one state could treat patients anywhere in the nation, and accountable care organizations would be exempt from telemedicine fee-for-service restrictions.
Finally, hospitals would receive incentives to use telemedicine technology to lower readmissions. This is in line with healthcare reform, which is penalizing hospitals if too many patients are readmitted within 30 days. Hospitals that miss the mark could lose up to 1 percent of their annual Medicare reimbursement.
David Lindeman, director of the Center for Technology and Aging and co-director of the Center for Innovation and Technology in Public Health, both within the Public Health Institute, says that provision of healthcare reform is driving organizations to determine how they can ramp up their telemedicine efforts beyond the pilot stage and start to incorporate them into care management strategies. With that, says fellow CITPH co-director Andrew Broderick, comes cost savings as well as a more productive and more efficient clinical staff.
The PHI recently examined three case studies in telemedicine adoption. In all three cases, Broderick says, the pilot projects succeeded because leadership saw the value of expanding the use of technology to accomplish a larger strategic initiative, whether it's reduced readmissions, better patient engagement or improved long-term care for those with chronic conditions.
United Kingdom Also Experiencing Telemedicine Growing Pains
Strong leadership also drives telemedicine adoption in the United Kingdom. There, as in the United States, most pilots have been initiated at a local rather than national level, says Tola Sargeant, director of analyst firm TechMarketView. That said, those programs thrive when there's a close relationship between national and local health authorities, she adds. This is important; in Britain's healthcare system, telemedicine benefits National Health Service hospitals (which lower their costs as admission rates go down) at the expense of local social care providers (which take on the responsibility for home care).
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