Telemedicine is an inarguable boon to modern care. By complementing traditional in-practice services with telemedical offerings, healthcare providers can extend specialty consults into the most remote rural clinics, cut down on the time patients wait for care, and even reach those who might have otherwise foregone the time and expense of in-person care.
The benefits aren’t limited to patients, either; telemedicine improves practice efficiency, provides quicker access to specialty consults, draws in more revenue from local patients who choose to receive care from remote specialists, and empowers rural providers to take advantage of virtual opportunities for continuing education. Integrating technology-powered health solutions can be a cost-saver for institutions, too; according to a recent report from Health Affairs, case study Emory Healthcare saved the Medicare program $4.6 million in fifteen months with its tele-ICU program.
The potential benefits of adopting telemedicine solutions are clear and appear to far outweigh the upfront cost of integration– and yet, the rate of that adoption is surprisingly underwhelming. According to a recent survey from HIMSS Analytics, provider telemedicine use in the United States hovers at an adoption rate of just 71%. This is an impressive climb from 2014, when the rate stood at 54%; however, it is not as high as one might reasonably expect given the potential for gain. The adoption rate for payers is similarly low — one 2018 study from KFF found that only 67% of surveyed employers report including telemedicine in their largest-enrollment health plans.
Despite its apparent potential for care improvement and cost savings, telemedicine has not been given a chance it deserves — and part of the reason, I believe, is due to problems in integration.
Let’s consider the issue further.
Lackluster Buy-In
Clinicians need to be willing to use telemedicine tools — otherwise, it won’t matter how much time and resources an institution pours into establishing technology-powered care solutions. Today, telemedicine adoption overwhelmingly centers in counseling-centered disciplines such as psychiatry and pediatrics. It has significantly fewer users in general practice — and even less in specialized fields. Overall, physician belief in current telemedicine-driven offerings is underwhelming; according to a recent survey by SERMO, a global social network for physicians, just 15% of U.S. doctors believe that their state is is doing a good job of integrating telemedicine.
The lack of enthusiasm from providers is partly rooted in uncertainty. Clinicians and care staffers are afraid that by embracing telemedicine, they will inadvertently increase their already-heavy workloads, stretch themselves too thin, and be unable to virtually provide the same high-caliber care that they would in person. These worries are valid but avoidable. If institutions can craft a defined package of telemedical service offerings and hold comprehensive training sessions that explain the utility of telehealth solutions, they can overcome the problems posed by a lack of knowledge and boost staff engagement.
Regulatory and Legal Barriers
Telemedicine empowers physicians on either side of the country to consult on a patient’s case; however, it isn’t always clear whether they should. Inconsistencies between state-by-state licensures and regulatory frameworks can make consults across state lines difficult — for example; virtual providers cannot currently prescribe medications without an in-person physician to confirm the recommendation. To make matters more difficult, organizations often need to wade through countless layers of bureaucracy and climb over technological barriers to share patient data across service boundaries.
Unclear Reimbursement Schemes
Worst of all for physicians is the lack of consistency in regards to reimbursement. When providers begin virtual consults, they want to know that their time is as valuable to a remote patient at a distant facility as it is to a patient they see in person. If they do have that certainty or are unsure of when or how they should expect that compensation, they may not want to risk taking on virtual consults.
All of these concerns are valid — and fixable. With all of the potential benefits telemedicine offers, providers today cannot afford to be intimidated by the challenges integration poses. Instead, they need to establish a transparent training model that teaches providers how they can benefit from using telemedicine offerings and provides some guidance on how to use them. The institution should also have a clear idea of any regulatory issues or compensation questions providers might face and prepare solutions before system rollout.
There is not a single perfect way to approach telemedicine, but one point is for sure — we can do better than we are now.
