Telehealth, also known as telemedicine, is seen by many to be an integral part of the future of healthcare in general and care coordination in particular. This attitude is reflected in how quickly telehealth options have been expanding over the last several years. However, there are still barriers to overcome before telehealth can expand to its full potential.
Why Is Telehealth Growing So Fast?
Until recently, the financial viability of telehealth services had been a major barrier to their expansion. This was partly because many states previously had policies which prevented telehealth providers from being reimbursed at rates that would make the services sustainable. As the benefits of telehealth have become more apparent, the last several years have seen the majority of states pass legislation aimed at addressing these reimbursement challenges. These changes have often included parity laws specifically designed to make telehealth more financially viable in rural areas.
Insurance companies have also been expanding telehealth coverage. A recent survey shows that, in the states where they are legally allowed, more than 95% of employer health plans will soon include some level of telehealth benefits. About 56% of those will also include telehealth-based behavioral health benefits. In addition to private insurance companies embracing telehealth, the Centers for Medicare and Medicaid Services (CMS) have announced that 2020 Medicare Advantage plans will expand telehealth benefits to all enrollees, not just those living in rural areas. However, the standard Medicare plans will continue to include their geographic restrictions on telehealth.
How Is It Being Used?
When many people think of telehealth, the most common image that comes to mind is a video chat with a remote physician or mental health provider. While video consultations are an important part of telehealth, particularly in behavioral health, the technology allows for much more than that. For example, there are electronic stethoscopes that allow high quality sounds to be recorded and transmitted. There are also otoscopes, the device a doctor would use to check a patient’s ears, that can be connected to smart devices for digital video sharing. A group has even been developing a special smartphone camera attachment that would allow for complete eye exams to be administered and then reviewed by an ophthalmologist remotely.
While everyday people would not generally have these diagnostic tools at their disposal, telehealth is not just for consultations from the comfort of home. One very common use of telehealth technology is from one facility to another. For example, a patient might be in a rural health clinic or small hospital that lacks the necessary specialists to address their needs. The available medical staff could then use telehealth technology to consult with a specialist at another location without having to transport the patient.
Telehealth and Care Coordination
One area where many see telehealth technologies as becoming a vital asset is in care coordination. Care coordinators often work with underserved populations who may benefit from an expansion of affordable healthcare that could be provided by telehealth services. The technology itself gives providers the ability to record, report, and securely transmit health data, which could then allow care coordinators an unprecedented level of transparency into the care and progress of their clients. There is even the potential for real-time remote collaboration between providers, patients, and care coordinators as they either develop or assess the progress of comprehensive care plans.
Are There Concerns?
While telehealth adoption is growing quickly, there are still concerns that will need to be addressed as services expand. For example, cybersecurity. Any provider of telehealth services is required to use a secure and encrypted internet connection, but what about the patient? Many people rely on either their home internet or mobile data. While these options may have some level of security, they are unlikely to be totally protected. A patient could potentially face privacy issues if they are transmitting private information or holding sensitive health consultations, and their network is accessed by a third party.
Another critical barrier to expanding telehealth services is the availability of reliable internet connections. Many of the same areas that lack requisite health services also lack dependable broadband internet. This means that telehealth services, particularly video-based consultations, may either be unreliable or completely unavailable without extensive, and potentially expensive, infrastructure updates.
Like any other newly developed technology, there are also questions about how telehealth is being used and how it should be used. For example, there are concerns about if doctors really know how to utilize the technology correctly. Simply put, the skills needed to take full advantage of telehealth technology are different from those needed to be successful in a traditional clinical setting. Some medical schools have begun offering telemedicine and digital health courses, but there are physicians who believe that telehealth needs to become its own medical specialty in order to address the level of training that may be required to master the necessary skills.
Though there are still concerns to be addressed and barriers to overcome, the supporters of telehealth services believe that the technology is going to become indispensable for patients, providers, and care coordinators. This is because telehealth has the potential to address two major concerns. The first is the expansion of affordable care to underserved populations, and the second is the facilitation of collaboration between patients and providers in order to achieve the best possible outcomes.