In some parts of Appalachia, there are more people with prescription opioid addictions than the local medical systems can treat. Telemedicine is addressing this shortfall by connecting addicts with doctors in far-flung and underserved parts of the country. In southwest Virginia, for example, the only two addiction treatment programs are 24 miles from Pearisburg, VA. For these residents, telemedicine is their best option to see a psychiatrist. At Carilion Clinic, patients speak with a Roanoke-based psychiatrist through a tablet in the exam room.
This summer, the U.S. Department of Agriculture funded five pilot, telemedicine projects for $1.4 million, to fight opioid addiction in southwest Virginia, Tennessee, and Kentucky.
That’s just one way telemedicine is saving lives. In 2017, expect to see telemedicine grow in capability and availability.
What we’ll see more of:
- More on-demand virtual visits, especially for simple matters
- More EHR support for virtual care
“[Healthcare delivery organizations (HDO)] are on the threshold of a seismic change in how they will deliver clinical care,” authors Mike Jones and Thomas J. Handler, M.D. wrote in Gartner’s latest Hype Cycle for Telemedicine and Virtual Care. “[HDOs] now recognize the value of virtual care and telemedicine as one part of the care delivery spectrum augmenting face-to-face care.”
“Over the next decade,” writes Martha Vockley, a principal of VockleyLang, LLC, “experts expect a flurry of experimentation to develop new, systemic delivery models for telemedicine — everywhere and for everyone, not just in remote locations or for select patient populations.”
In addition, according to Vockley, physicians are moving away from patient care alone, aka telemedicine, to a more holistic wellness care, aka telehealth. Telemedicine refers to remote clinical services. Telehealth includes provider training, health education, and provider training in addition to patient visits.
Factors driving the move to telemedicine in 2017
People want on-demand access to care.
Grand View Research Inc. predicts the market for telehealth hardware, software, and services will reach a whopping $2.8 billion by 2022 and says that consumer demand is behind the increase. People want easier access to better quality healthcare. Especially as the population ages, demand is growing, as older people have more chronic conditions and are less mobile.
More payers are moving away from fee-for-service toward pay-for-value. The Affordable Care Act encouraged HDOs to improve quality of care, focus on outcomes, and lower costs. A growing body of research is showing that telemedicine offers outcomes similar to face-to-face visits but with far lower costs for patients and HDOs.
The Grand View Research Inc. report claims that Community Care Plan of Eastern Carolina was able to double the number of patients it could see a week thanks to telemedicine.
“Ten years ago, telemedicine was technologically and financially so expensive that it was limited to the select few,” Yadin David, Founder of the Center for Telemedicine and eHealth Law, told Vockley. “You had to invest in building a room, buying all kinds of special cameras and large monitors and computers and high-speed communications. Now everybody who has a mobile device can download some apps and become a semi-healer.”
“Technological advances are making telemedicine more appealing, feasible, and affordable,” Vockley writes. Video and audio equipment is smaller, cheaper, and more reliable than ever before. And screens are continually getting sharper, lighter, and thinner. In addition, the population is now more connected to the internet than ever before, through Wi-Fi,3G, and 4G.
It’s pretty well-established that telemedicine is clinically effective. According to AMD Telemedicine, the National Library of Medicine has accepted more than 10,000 studies that show that telemedicine is safe and effective over a variety of clinical specialties, environments, and delivery methods.
Factors slowing the move to telemedicine:
One impediment to telemedicine is that doctors are only allowed to treat patients who live in the state they’re licensed in. Rather than disincentivizing telemedicine it really just limits how much telemedicine can help alleviate the discrepancies between high-demand and low-supply states.
Another factor is that 13% of Americans aren’t online, and that percentage has held steady over the past three years, according to Pew. And while seniors stand to gain a ton from telemedicine, they’re also the group most likely to say they never go online. More than 40% of Americans 65 and older do not use the internet. Same goes for rural Americans, who are nearly twice as likely as urban or suburban dwellers to never go online.
EHRs and telemedicine
Gartner’s Jones and Handler predict that EHRs with integrated telehealth functionality will replace today’s stand-alone telemedicine technologies.
“At Kareo, we believe in the value of integration,” Lea Chatham, Editor-in-Chief of Kareo’s Getting Paid blog, told me. “We offer a robust end-to-end platform for billing, practice management, and electronic health records.”
Kareo builds integrations with leading third-party solutions to help address other clinical, billing, and administrative needs to reduce data entry and related errors. “It improves workflow and simplifies the user experience,” Chatham said. “So we absolutely agree that not only in telemedicine but across the industry integration is the future of more efficient healthcare. And we believe there are different ways to be integrated to help ensure that practices have options.”
Kareo has responded to the telemedicine revolution by partnering with Chiron Health, a leading provider of telemedicine solutions. “Through our open API we have integrated our platform with Chiron Health’s software to offer an integrated option for telemedicine designed for independent practices,” Chatham said.
Evan Pankey, Product Manager at Amazing Charts InLight EHR, takes a slightly different view of telemedicine. “Contrary to popular belief, most telemedicine does not involve live video chat with a physician across the country who lacks a full picture of the patient’s health status,” Pankey said. “Our early exploration into telemedicine demonstrates that patients would rather receive remote care from a primary care physician they already know. Today’s telemedicine is more likely to be an Electronic Health Record system that adds to the clinical chart any messages, pictures, and videos sent by a patient to a physician using a smartphone.”
Gartner advice to HDOs
If you haven’t yet, Gartner recommends you put together a task force of your organization’s primary stakeholders to choose when to pilot a telemedicine offering.
As you plan your investments in and updates to infrastructure (such as EHRs), clinical workflows, and clinician training, keep telemedicine in mind.
Communicate telemedicine’s potential benefits to and take questions from patients to get their buy-in before testing it with them. Communicate how effective and cost-efficient telemedicine is to internal constituents and external payer organizations.
Telemedicine is bringing much-needed help to Appalachian addicts, older patients, and others. Expect telemedicine to grow in 2017, as demand increases, payers adapt, HDOs begin to see the value, and EHRs adapt.
To shop for a telemedicine-friendly EHR, start with our EHR software directory.
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