Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities.
Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.
Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.
Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by healthcare institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services.
Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth.
Telemedicine has been growing rapidly because it offers four fundamental benefits:
- Improved Access – For over 40 years, telemedicine has been used to bring healthcare services to patients in distant locations. Not only does telemedicine improve access to patients but it also allows physicians and health facilities to expand their reach, beyond their own offices. Given the provider shortages throughout the world–in both rural and urban areas–telemedicine has a unique capacity to increase service to millions of new patients.
- Cost Efficiencies – Reducing or containing the cost of healthcare is one of the most important reasons for funding and adopting telehealth technologies. Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
- Improved Quality – Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consultations. In some specialties, particularly in mental health and ICU care, telemedicine delivers a superior product, with greater outcomes and patient satisfaction.
- Patient Demand – Consumers want telemedicine. The greatest impact of telemedicine is on the patient, their family and their community. Using telemedicine technologies reduces travel time and related stresses for the patient. Over the past 15 years study after study has documented patient satisfaction and support for telemedical services.Such services offer patients the access to providers that might not be available otherwise, as well as medical services without the need to travel long distances.
There are several indicators that 2015 will be the year that telemedicine really takes off. Read any predictions related to healthcare and telemedicine is central in those discussions. Here are just some of the indicators:
The Global Telemedicine market in 2016 is predicted to be $27 billion, with Virtual Health Services making up $16 billion of that amount (BBC Research and Towers Watson.
By 2018, 65 percent of interactions with healthcare organizations will be done via mobile devices, and by 2018 -70 percent of them will have apps, offer wearables, do remote health monitoring, and even offer virtual care.
More than one-third of the money Google Ventures invested in 2014 went to healthcare and life-sciences companies.
Telemedicine will certainly deliver significant financial benefits and efficiencies for players in the healthcare space, including providers and insurance companies. For example, virtual health has the potential to reduce all doctor visits by 93 percent at a savings of $103 per visit ($1,067 per emergency room visit). Fifty percent of all doctor visits can be conducted virtually, and 70 percent of all electronic medical record (EMR) visits can be conducted virtually. The big winner in the rise of telemedicine, however, is the patient. With new technology and capabilities, the patient can receive faster, better quality care with superior outcomes.
Aditional Revenue, you will gain more patients by having this offering. You can give better coverage with visits from any location, in the modern world that we are in today most physicians have multiple sites and the demand to be highly productive from multiple locations are increasing daily, having a telehealth solution allows for more coverage, by having medical assistants available to see patients when you are not available again more revenue.
You can do all this by spending a the same amount of time seeing a patient in person, the real advantage is you can schedule the time that is best for you and your office staff to assist more potential revenue driving patients and still deliver high quality healthcare.
Your satisfaction scores and customer loyaly will increase, if you are seeing patients faster then the end result will be happier patients. You can do all of this by driving down the overall cost of healthcare and delays with payments from insurance carriers.
The last advantage is you are being progressive and competitive in the healthcare space. You are offering solutions to what could be looked at problems today, some offices are booked out months in advance, this new options will allow for a win/win for you and the patient.
Sometimes telemedicine is best understood in terms of the services provided and the mechanisms used to provide those services. Here are some examples:
Primary care and specialist referral services may involve a primary care or allied health professional providing a consultation with a patient or a specialist assisting the primary care physician in rendering a diagnosis. This may involve the use of live interactive video or the use of store and forward transmission of diagnostic images, vital signs and/or video clips along with patient data for later review.
Remote patient monitoring, including home telehealth, uses devices to remotely collect and send data to a home health agency or a remote diagnostic testing facility (RDTF) for interpretation. Such applications might include a specific vital sign, such as blood glucose or heart ECG or a variety of indicators for homebound patients. Such services can be used to supplement the use of visiting nurses.
Consumer medical and health information includes the use of the Internet and wireless devices for consumers to obtain specialized health information and on-line discussion groups to provide peer-to-peer support.
Medical education provides continuing medical education credits for health professionals and special medical education seminars for targeted groups in remote locations.
What Delivery Mechanisms Can Be Used?
Networked programs link tertiary care hospitals and clinics with outlying clinics and community health centers in rural or suburban areas. The links may use dedicated high-speed lines or the Internet for telecommunication links between sites.
Point-to-point connections using private high-speed networks are used by hospitals and clinics that deliver services directly or outsource specialty services to independent medical service providers. Such outsourced services include radiology, stroke assessment, mental health and intensive care services.
Monitoring center links are used for cardiac, pulmonary or fetal monitoring, home care and related services that provide care to patients in the home. Often normal landline or wireless connections are used to communicate directly between the patient and the center although some systems use the Internet.
Web-based e-health patient service sites provide direct consumer outreach and services over the Internet. Under telemedicine, these include those sites that provide direct patient care.
Does Medicare or Medicaid pay for telemedicine services?
Medicare: Yes… in certain circumstances. Many “telehealth” services, such as remote radiology, pathology and some cardiology, are covered simply as “physician services.” For traditional fee-for-service beneficiaries living in rural areas, Medicare covers physician services using videoconferencing. The ~14 million beneficiaries in Medicare Advantage (managed care) plans, have complete flexibility in using telehealth, as long as their provider offers the service.
Medicaid: Almost every state Medicaid plan specifically covers at least some telehealth services, however states vary greatly in their coverage.
Forty-two states now offer some form of Medicaid reimbursement for telehealth services, and 16 states mandate that private payers cover what the states deem as telehealth services (definitions can vary by state) when they are medically necessary and otherwise would be covered if they were provided in a face-to-face office visit. Reimbursement rates for telehealth services may not match those related to face-to-face services. Before providing or billing any telehealth services, check with individual payers to determine whether they reimburse for such services and, if so, which services and how much.
