Telemedicine and telehealth have arrived!
Although the two terms are sometimes used interchangeably or together to describe a single phenomenon, the American Telemedicine Association distinguishes them as follows: “Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telehealth is … a broader definition of remote healthcare and [does] not always involve clinical services.” Whether the distinction is important to you or not, according to a recent survey by the National Business Group on Health, 48% of large employers intend to make it available to their employees this year in states where it’s legal.
Why all the fuss?
From an employer’s perspective, the promise of telehealth and telemedicine provides another strategy for reducing health insurance costs. It can also minimize employee time away from the job, as it did for one technology firm. The benefits of telemedicine, its offshoot “mHealth,” and telehealth, are many. Access to healthcare, especially to those living in rural areas, is a major one, as is the ability to reach people where there‘s a shortage of primary care physicians. In the workplace, employees like the instant access to medical care, not to mention the cost factor, that usually involves a flat fee equal to or sometimes less than their copay.
While there are no strong opponents to telemedicine and telehealth, there are barriers that prevent it from really taking off, namely legal and regulatory issues (especially at the state level), privacy and security concerns, lack of physician buy-in, and claims reimbursement issues. For example, one study released by Mary Ann Liebert Publishers examines private payer telehealth reimbursement in the United States. The data provides insight into the difficulties experienced by providers in receiving payment for telemedicine services, and points out how telemedicine reimbursement claims are treated differently from in-person care by physicians. These barriers to reimbursement include greater denials for telehealth services than for in-person services, billing and coding issues, and a pre-authorization requirement for telemedicine services not needed for traditional care.
The jury is still out on the impact of telehealth on the quality and cost of care. An article in Health Affairs describes a claims analysis study performed for a large California agency’s public employees who use Teledoc services (Teledoc is one of the largest US telehealth providers). Compared with physician office visits for the same type of acute medical issues, the analysis found that those who used telehealth services were younger, less likely to have used any type of health benefit before, and less likely to have a follow-up visit. The quality of care the employees experienced with Teledoc’s telehealth services was difficult to assess, leaving this an area that warrants further investigation.
More has been done with standards of care in the practice of telehealth. At the state level, New York and California view telehealth as a tool in medical practice, and not a separate form of medicine, and as recently as last May, state medical boards adopted policy guidelines for the safe practice of telemedicine.
Although telemedicine has been around for four decades, technological advances are driving these services to the forefront. As with all disruptive technology, the promise of change and transformation for the good of society is here to stay even in the area of healthcare delivery. Why else would this market be projected to reach $27.3 billion by 2016 and venture capitalists are offering seed money for start-up firms in telehealth and mHealth?
Does your firm offer telehealth and telemedicine services?
What do you see as barriers to telehealth in your workplace?
Are your employees embracing online health services?
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