How Telemedicine Transforms Care, Reduces Costs

As medical practices of all sizes look at ways technology can increase efficiency while keeping costs under control, a House committee put a congressional microscope on the advances made in telemedicine in recent years.

As medical practices of all sizes look at ways technology can increase efficiency while keeping costs under control, the House Committee on Small Business put a congressional microscope on the advances made in telemedicine in recent years.

In a statement from the committee, Chairman Chris Collins (R-NY) said the focus of the hearing was to look particularly at smaller practices to see how telemedicine was helping them survive in a market filled with larger competitors. The committee defined telemedicine as “when the provider and patient are separated by distance but able to interact through technology.”

“Over the past few years, there has been a lot of debate about reforming America’s health care system,” Collins said in the statement. “One of the best ways to reform healthcare and reduce costs is to allow the private sector to improve the industry through innovation and increased access.”

The congressman noted that as the technology involved in telemedicine improves, it is important that politics not get involved to hamper that progress.

“Some physicians and telemedicine advocates are concerned that regulatory barriers will keep this cost-saving and useful technology from reaching its full potential,” he said. “Washington must work with the medical community to make sure technological advances, like telemedicine, are able to thrive so that they improve the quality and affordability of care.”

The committee’s statement cited a study showing telemedicine’s potential for growth. Parks Associates noted that in 2013 around 900,000 patients utilized some manner of telemedicine. The study predicted that by 2018 the number would increase to more than 22 million patients.

Telemedicine has become more accepted by healthcare practices of all shapes and sizes, Karen Rheuban, MD, Senior Associate Dean for CME and External Affairs Director at the University of Virginia Center for Telehealth, said in her testimony at the congressional hearing.

“Telehealth is an essential tool to address the significant challenges of access to high quality care for both acute and chronic disease management, to mitigate workforce shortages, improve population and lower cost of care,” she noted. “There are many opportunities for small practices to integrate telehealth models into every-day practice. However, even for large healthcare systems, managing and navigating the complex legal and regulatory environment which impacts the practice of healthcare using telehealth tools can be challenging.”

Rheuban said for the smaller practices with just a few doctors, telemedicine can be an important tool; however, she noted that administrative and regulatory challenges can be overwhelming.

“Thus it is imperative that we create and promulgate policies that foster certainty, transparency, high quality, secure, and sustainable solutions that empower patients, providers, and payers to adopt 21st Century models of care,” she said.

Not all the reviews of telemedicine were favorable during the congressional hearing. Brenda Dintiman, MD, FAAD, at Fair Oaks Skin Care Center in Fairfax, VA, said she has seen problems affecting not only the practitioners but also the patients.

“The largest barrier as noted is reimbursement for telehealth services,” she reported. “Without assured reimbursement, providers and patients are unlikely to utilize telehealth. While Virginia law addresses coverage for telehealth services, this does not guarantee access with all private insurance and many states do not have similar policies.”

According to the Healthcare Information and Management Systems Society, a bill is being introduced to help regulate reimbursement for telemedicine. The Medicare Telehealth Parity Act of 2014 would help make the system of reimbursement more balanced for patients across the country.

The HIMSS story noted that “Currently, telehealth services are only reimbursed for beneficiaries who seek care at approved healthcare facilities in designated rural areas.” If the bill is signed into law in its current form, the project would expand into urban areas and increase the number of clinics patients could utilize.

The bill would also ease restrictions on “store-and-forward technology,” where a patient’s data is collected at one time and analyzed at a later point. It would also allow for the reimbursement of remote patients who are being monitored for chronic health conditions.