Barriers to telemedicine? What barriers?
November 8, 2017
In today’s society, a trip to see a physician is simply a click away, a far cry from the hassle of getting in the car, driving hurriedly to make it to the appointment and then sitting for what seems like hours in the waiting room. Telemedicine allows for a patient to be seen by a physician right away compared to the 20 day average wait to be seen in person, while enjoying the convenience being in his or her home. Such a system has been cited as improving the quality of a patient’s care, encouraging a patient to feel secure receiving personalized treatment in the comfort of the patient’s home. But with all this talk about what benefits telehealth platforms bring to a patient, one begs to ask the question “What about the doctors?” Critics of telehealth argue that telehealth reimbursement law is so complex that physicians struggle with knowing their own state’s reimbursement policies. Critics of telehealth are also quick to point out that, while telehealth can be seen as more convenient and secure to most, not every patient will so easily accept a telehealth program. These same critics also say that a telehealth initiative is not easily integrated with an existing practice, adopting a new technology requires training, awareness, and education. With all of these gray areas, it is easy to see where the healthcare professionals looking to take a practice online are getting lost in translation.
The same level of care is achieved, the mode of delivery is different
One of the major points that critics of telehealth like to point out is that telehealth reimbursement policy varies from provider to provider in each state, leaving doctors mystified on whether or not they will get reimbursed for services rendered. Ed Bostick of the Colorado Telehealth Network agrees with this point, saying that “reimbursement levels for providers may not always be consistent, which is a disincentive for doctors to do telehealth.” The inconsistency of telehealth reimbursement is somewhat of a moot point, as telehealth is not a new service rendered but rather a different delivery method. As Kofi Jones of Forbes points out, the same level of care is achieved through a telehealth systems, the mode of delivery is different and “these providers have already negotiated a rate for this care; they aren’t adding new services.” Lawmakers are making moves to acknowledge this fact, 30 states have a parity law in place, and 8 other states have proposed parity legislation waiting for further review. While there are restrictions in Medicare and Medicaid policy regarding locations of originating and distant site, there are also concessions made for telehealth providers, like being reimbursed a site facility fee. Federal State Employee plans are also approving and drafting legislation that allows for telehealth services to be eligible for reimbursement. With concentration on parity law the past few years, there has been great strides to improve reimbursement for healthcare providers performing telehealth services from state to state.
Most patients are receptive to telehealth programs because they know how crucial the benefits are
In addition to reimbursement, critics have been swift to tout that not all patients will be so receptive to adopt a telehealth program. According to a study conducted by Fierce Health IT, 36.7% of patients responded that they would feel uncomfortable with a visit via telemedicine. However this same study concluded that 70% of patient respondents would be quick to integrate with a telehealth program if the solution offered one of the following four benefits: more convenient scheduling options, lower cost, less time spent in the waiting room, and the ability to access an appointment in their own homes. Slow adopters to telehealth argue that jumping online to randomly select a doctor makes them feel less confident about their overall experience, including the diagnosis. Telehealth initiatives of today have become cognisant of this fact, and have responded with “two specific forms of telehealth: services that allow consumers to review and choose which doctor they’d like to see, and platforms that allow providers to establish links with their own patients (and vice versa).” The truth of the matter is that most patients are receptive to a telehealth program because they realize how crucial the benefits are to the total experience. Although one fifth of America’s population live in rural areas, only 9% of physicians practice in these rural settings. Telehealth solutions have become a huge problem solver for this 20% of the population, because people in rural areas a more embracing of telehealth solutions over their almost nonexistent access to in person care.
Almost all telehealth platforms offer a step-by-step guide as to how the software works
Another factor influencing the barrier to entry with telehealth initiatives is the concern with doctors obtaining the training and know how to properly conduct a telehealth visit with a patient. Critics of telehealth will argue that physicians are increasingly worried about the “potential that virtual visits could jeopardize care by not meeting professional standards for a clinical encounter.” As telehealth programs continue to spread across the world, the stigma associated with the amount of training and knowledge about these programs required by doctors should be eradicated. There are resources for these innovative practitioners, including “Twenty new institutions [that] recently joined the American Medical Association’s effort to bring medical education into the 21st century and are involved in projects such as developing advanced simulation and telemedicine technologies,” as well as medical educators that help practice different simulations and conversations that may arise during a telehealth visit. Almost all telehealth platforms offer a step-by-step guide as to how the software works, and how easily they can convert their practice to an online one, and there are countless websites and journals dedicated to the success of a telehealth initiative, from marketing tips to troubleshooting technical issues. Most of these resources are free and an easy read, providing a nearly seamless entry for the healthcare professional looking to provide online health services.
The telehealth industry is growing at a rapid rate
Opponents of telehealth initiatives are quick to point out that reimbursement to healthcare providers is spotty, some patients are not as receptive to telehealth programs and that the training and education needed is not as accessible as it should be, but not as quick to identify the flaws in their own arguments. These critics fail to take into account the growing demand of telehealth services, and the 32% annual growth rate of the telehealth industry itself. This industry is growing at a rapid rate due to the successes shown between the patient and the provider. With a pool of patients that want telehealth services and a plethora of resources available about transitioning to an online practice and how to be reimbursed, healthcare professionals are poised to make great leaps in the healthcare technology field.
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