Telemedicine: On the Horizon and Beyond

The electronic application and communication of delivering health care to patients in various locations, known as telemedicine, is a major debate. As telemedicine continues to become more widely understood and recognized for its potential to be an efficient, more cost-effective method of receiving health care, its acceptance is growing.

The concept of “virtual physicians” used to be a creative notion found in sci-fi movies and novels. Today, it’s a real-life discourse among private practice offices, health care systems and insurance carriers and throughout Washington, DC. Physician shortages in the United States are projected to rise to approximately 91,500 by 2020, according to American Medical News. This predicted scarcity of professionals in the medical field, in addition to the increasing demands of the aging baby boomer population, seems to confirm that some form of telemedicine will have a place in the future of health care.

Kevin Hauser, CEO of MedeFile — a health care technology and services organization that also works in the field of electronic personal health records and telemedicine — believes that despite the current legalities and patient information collection obstacles of telemedicine, it is ultimately an inescapable wave of the future.

“There’s certainly still a long way to go in ironing out the details of utilizing and implementing telemedicine into a large scale, health care sector,” says Hauser. “I don’t believe face-to-face visits should or will go astray, but for the patient who live in rural areas, experience after-hours medical issues or don’t have insurance, a video conference with a qualified physician can help save significantly on emergency department costs — the most expensive element of health care spending in America.”

Hauser believes the immediate areas of medicine that can greatly benefit from and stand to grow rapidly utilizing telemedicine include neurology, radiology, pathology and psychiatry. From an acute standpoint, there are a number of innovative companies seeking to bring on primary care providers and general practitioners to help patients avoid inconvenient travel; address immediate questions and concerns; and provide professional, appropriate advice for treatment.

Telemedicine isn’t limited to video consultation, but also includes other forms of services bridging the distance or time restriction gaps, including telephone and e-mail.

The Digital Age

There are definite challenges to surmount with telemedicine, according to Hauser.

“There is a substantial need for a set of standardized guidelines for providers to work along with and follow in order to deliver effective care,” Hauser says. “Many legal aspects of the technology must be hashed out, and several health care professionals are still skeptical. The fact is the technology is here, it is available and it’s a huge growth opportunity that isn’t going to disappear.”

The ultimate goal of telehealth technology is to improve rural populations’ access to care and specialists, decrease cost and travel time associated with seeking medical assistance and to reduce hospital admissions and patient transfers — not to replace physicians or office visits.

“I would advise hesitant physicians to learn about the great benefits this technology can provide,” encourages Hauser. “Don’t run from telemedicine; instead, embrace the technology and its possibilities. Become apart of the dialogue of figuring out the technicalities of telemedicine so that we may implement its assistances safely and most effectively.”

To learn more about MedeFile and its services, please visit MedeFile.com.

MD News May 2011

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Joint Commission lauds CMS telemedicine revision

The Centers for Medicare & Medicaid Services (CMS) has taken “a giant step” toward removing unnecessary barriers to the use of telemedicine for medically necessary interventions, according to a statement by the Joint Commission.

CMS' action fits with the Joint Commission’s stance on the need to limit "overly burdensome requirements that may impede patient access to healthcare services,” said Mark R. Chassin, MD, MPH, president of The Joint Commission, in a statement posted on the Joint Commission's website.

The rule, which applies to all hospitals that participate in Medicare and to inpatients at critical-access hospitals (CAHs), upholds The Joint Commission’s practice of allowing the hospital or CAH to use information from the distant-site hospital or other accredited telemedicine entity when making credentialing or privileging decisions for the distant-site physicians and practitioners.

“The Joint Commission is very pleased that CMS has revised its telemedicine requirements to provide more flexibility to hospitals and lessen their regulatory burden. This is an especially positive step for improving access to care for patients in rural areas,” Chassin stated. “Of particular importance is the fact that [CAHs] will have additional avenues to benefit from the services of particularly skilled physicians and practitioners.”

There would be "an adverse effect on the access to telemedicine services if Joint Commission-accredited hospitals were not allowed to use, for telemedicine practitioners, the credentialing and privileging decisions made by other Joint Commission-accredited facilities, especially since these facilities are held to the same rigorous requirements," the Joint Commission predicted.

“The Joint Commission believes that the previous CMS requirements placed an undue burden on many organizations because they did not improve the quality of services, the accountability of physicians and practitioners, or the effectiveness of the credentialing and privileging processes,” Chassin stated.

The Joint Commission will evaluate its telemedicine requirements to reaffirm that they are aligned with the requirements of CMS, he added. The new rule becomes effective July 5.

An independent, not-for-profit organization based in Oakbrook Terrace, Ill., The Joint Commission accredits and certifies more than 19,000 healthcare organizations and programs in the U.S

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