There has been a lot of news recently about the increased use (and future growth) of telemedicine. One report predicts the market for telemedicine devices and services will reach nearly $2 billion in less than five years. "New wired and wireless broadband networks are saving time and costs in the medical environment. They allow specialists to remotely triage, diagnose, and monitor medical cases by viewing data and images conveyed wirelessly to their locations. They also enable specialists to access medical records and medical reference material that are germane to a specific patient's case," say analysts at market research firm Pike & Fischer.
Researchers at the University of Missouri estimate that the U.S. could save $1.5 billion in healthcare costs if health plans encouraged patients with chronic diseases to engage in frequent telemedicine visits with their doctors.
In yet another study, researchers at the University of California San Diego Medical Center found that stroke patients in remote locations receive more accurate treatments through the use of telemedicine consultations than with telephone consultations. In this case, researchers define a telemedicine consultation as including real-time two-way audio, video, and digital imaging. In fact, they say correct treatment decisions were made in 98% of telemedicine consultations compared to 82% of telephone consultations.
Despite all of the reported benefits associated with practicing telemedicine, there are still major obstacles that have prevented adoption of this technology. Lack of reimbursement, the high cost of purchasing and installing the equipment, and confusion surrounding the legality of providing patient care across state lines are among the most commonly cited reasons healthcare providers say they have chosen not to invest in the technology.
Karen Rheuban, MD, president-elect of the American Telemedicine Association recently cited funding as one of the greatest barriers affecting the dissemination of telemedicine when she appeared before the House Agriculture Subcommittee on Specialty Crops, Rural Development, and Foreign Agriculture. In her testimony, Rheuban urged Congress to commit to a greater level of funding support. "Current Medicare reimbursement policies and uncoordinated agency definitions of rurality" have kept providers from adopting this technology at a greater rate, she says.
Even though providers continue to push for increased funding, the government doesn't seem to be in any rush to give it to them. In its response to requests that that Diabetes Self-Management Training and critical care services be added to the list of Medicare telehealth services, the Centers for Medicare and Medicaid Services recently recommended against adding those services to the telehealth list, saying "We have no evidence suggesting that the use of telehealth could be a reasonable surrogate for the face-to-face delivery of this type of care."
Still, the industry did receive a bit of good news in late June when the House of Representatives passed legislation expanding the list of Medicare telehealth originating sites, adding hospital-based renal dialysis centers, skilled nursing facilities, and community mental health centers to the list of sites that are eligible for reimbursement. Advances in broadband technology have also increased the scope of providers who can afford to practice telemedicine. With a high-speed Internet connection and a computer, even the most rural hospital operating on a shoestring budget can have access to specialists that were previously unavailable to them.
The reports predicting that the practice of telemedicine will save the healthcare industry billions of dollars while vastly improving the quality of patient care may eventually prove to be prophetic. Before that happens, however, most experts agree there is going to have to be broader financial support from payers in both the private and public sectors.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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Fewer than half of eligible U.S. patients received medical devices to shock their faulty hearts back into rhythm, though the products can cut death rates by more than one-third, according to a study.
Hospitals implanted the $33,000 cardiac resynchronization therapy devices in 12.4% of heart failure patients, according to a survey of 34,000 cases. Cost is a factor at some hospitals, as is the lack of trained specialists to implant the devices and physicians' reluctance to embrace the relatively new technology, say the study's authors.
A new "employee" at Bethesda Memorial Hospital in Boynton Beach, FL, is ridding healthcare workers of various mundane tasks such as running errands. Tray-C, an automated transportation system robot produced by Aethon Inc. of Pittsburgh, helps with the tracking and delivery of hospital meals and supplies. The system has been in place since early June.
Steven Chang, a former Stanford resident now at UC Davis Medical Center in Sacramento, reserves a particular passion for Epocrates Rx, free software created by a San Mateo company that provides clinicians with prescription drug and formulary information such as dosage levels, contraindications, and insurer co-payment amounts. But when he tried to combine that passion with the iPhone he hit a virtual wall. In addition to preferring the iPhone, Chang was tired of juggling multiple devices as he moved around the clinic. Thus began a digital crusade by the 30-year-old primary-care physician.
Community Health Network, an Indianapolis-based hospital system, wants to bring the same sort of computerized convenience of an ATM to healthcare through its new myCommunity program. The service offers a variety of free tech tools to patients who sign up to receive a credit-card-sized "myCommunity" card. It will also feature express check-in kiosks to be installed at one hospital first, then throughout the system eventually. Patients will swipe their myCommunity cards and use touch screens to complete the inpatient and outpatient check-in process. MyCommunity also allows patients to keep track of their conditions and medications.
A Harris County (TX) Hospital District administrator probably violated the Health Insurance Portability and Accountability Act when she downloaded medical and financial records for 1,200 patients with HIV, AIDS, and other medical conditions onto a flash drive that later was lost or stolen. The hospital district has released little information about the situation, but issued a brief statement saying patients affected by the breach would receive a letter in the mail and would be allowed to enroll in a credit protection program at the district's expense. The district has strengthened its policies and procedures regarding the use of transportable media devices, according to the statement.