Telemedicine – Today

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The industry has evolved and it’s still a confusing picture.  There are several key components of telemedicine including:

> Live Video Conferencing – between physician (or other healthcare practitioner) and patient (or physician and physician)

> Store-and-Forward – the transmission of a patient’s record or data to a healthcare provider

> Remote Patient Monitoring – the collection and transmission of a patient’s health and medical data in real time to a caregiver

> Mobile Health (mHealth)– using any mobile communications device, including smartphones and tablets, along with hundreds of software applications to support healthcare.

Let’s not debate the difference between telemedicine and telehealth, for this article they are one and the same.

In his just published cHealth blog, Dr. Joseph Kvedar of Partners Health care talks about the importance of adding Remote Patient Monitoring to a telehealth service:  https://chealthblog.connectedhealth.org. Simply put, “Remote monitoring is critical to move us from one-to-one models of care delivery to one-to-many.”

Telemedicine programs have evolved to support specific disease conditions such as diabetes and congestive heart failure.  Target populations include geriatric and pediatric patients. Specialties have emerged in areas such as tele-psychiatry, tele-pathology, tele-dermatology, tele-ophthalmology and my personal favorite, teleradiology.   By my count, there are over 120 commercial telemedicine/telehealth providers and close to another 100 teleradiology companies.

Several firms have raised tens of millions of dollars to develop and promote their services.  Here is a list of 11 top companies:  http://www.healthcareitnews.com/news/comparing-11-top-telehealth-platforms-company-execs-tout-quality-safety-ehr-integrations. One Teledoc (TDOC) is publicly traded (but still not profitable).  Most of these target insurance companies who now offer telemedicine to their clients and recent data shows that 70% of larger employers offering telehealth as a benefit (although utilization remains low).   I’m happy to represent one below-the-radar company with an outstanding feature set, www.myhealthconnection.tv.   Telemedicine has been shown to provide great clinical benefits to under-served populations (third world countries and rural areas) but economic justification remains elusive.  Here is a recent article describing 8 reasons why telehealth is gaining momentum right now: http://www.healthcareitnews.com/news/8-reasons-why-telehealth-gaining-momentum-right-now

Many hospitals now offer telemedicine services with a major focus on reducing hospital re-admission to avoid Medicare penalties.  Most hospitals use a teleradiology company to cover overnight shifts, but that trend has shifted somewhat as radiology groups are reorganizing to capture lost revenue. Barriers to telemedicine acceptance exist including those of regulation and reimbursement but through lobbying and educational efforts, those are finally changing (as now most of the states have parity laws for the reimbursement of telemedicine).  Medicare remains a stubborn hold out. The annual American Telemedicine Association meeting in 2017 had over 6000 attendees.

On a personal note, in conjunction with www.thecasteltongroup.com we have just submitted a proposal to be considered as part of the “First 1000 Days on Medicaid Initiative sponsored by the New York State Department of Health. See https://www.health.ny.gov/health_care/medicaid/redesign/first_1000.htm.  We have proposed five telemedicine pilots as part of this program and we should know the status by the end of this month.  Stay tuned.  And stay tuned for next month’s “The Future of Telemedicine”.

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