According to the Harvard Business Review, 84 percent of U.S. patients said that they would use telemedicine services if they were offered. This may explain why the global telehealth market is expected to reach $93.45 billion by 2026.
Telehealth is expected to grow -- but if this is the case, why isn't this technology more widespread? According to Definitive Healthcare’s data, only one-third of inpatient hospitals and 45 percent of outpatient facilities provide telehealth solutions or services; the movement toward telehealth may be stalling due to federal policy and regulations. After all, the Centers for Medicare and Medicaid Services (CMS) just finalized expansion of provider reimbursement for telehealth and virtual care services in late 2018. But, ready or not, telemedicine is on its way into the fold, steadily increasing in popularity -- and set to change the future of healthcare as we know it.
Like anything else, there are some upsides and downsides to this technology. Let's explore two benefits and two challenges associated with telemedicine, and what we might expect to see in the coming years:
Benefits of telemedicine
1. Improving rural care and solving staffing shortages
Rural hospitals are key points of care in the communities they serve and are often the only care facility accessible to patients in remote areas. However, rural hospitals are closing at an alarming rate due to lack of resources and dwindling patient populations, leaving patients at risk without access to early or consistent medical intervention.
And, as provider shortages deepen, it's harder than ever to find physicians willing to relocate to rural hospitals or specialists that can provide more targeted care. Telehealth platforms can relieve some of the strain from healthcare staffing shortages by connecting patients to remote providers and keeping patients in network. This is most impactful when patients are referred to specialists — particularly psychiatrists, cardiologists, obstetricians, and oncologists — and could prevent long-distance and expensive travel that would otherwise be a barrier.
Currently, the FCC is working to enable telemedicine technologies across rural America through the Connect America Fund, which supports new broadband infrastructure in remote areas. These installations can enable city-based physicians to treat more patients, connect specialists to rural hospitals, and give patients access to a wider pool of physicians.
With these advancements, rural patients may experience better diagnostic analyses and follow up care treatments with in-home monitoring.
2. Greater patient satisfaction
With the shift toward value based care and consumerization, it is now, more than ever, essential to cater to patients' needs. Things like reduced wait times and lower prices appeal to patients, and their ratings help improve HCAHPS scores and other quality metrics associated with value based care.
Reduced wait times: Telemedicine technologies help patients avoid long waits in a doctor's office for an answer to a simple medical question. In fact, a fast telemedicine check in can help patients get faster opinions on health concerns, allowing them to go forward with further treatment in person, if needed. A University of Iowa study revealed that rural hospitals using telemedicine in theirERs saw patients six times more quicklythan hospitals which did not use such technology.
Fewer life interruptions: Telemedicine is decreasing the need for patients to take time off work or schedule childcare.
Challenges associated with telemedicine
1. Security and fraud concerns
There are significant privacy and security risks in telehealth systems that can adversely affect patients’ and clinicians’ level of trust and willingness to adopt and use the system. With telemedicine, there are a few concerns:
Physicians must ensure they’re in a location where no one can overhear the virtual visits, which would violate HIPAA’s privacy and confidentiality requirements.
There is concern that some telehealth devices may collect and transmit information on activities like substance abuse or whether the house is unoccupied.
Smartphone apps may share sensitive data—such as location—with advertisers and other third parties.
Despite efforts to create secure devices and apps, some contain serious flaws, and hackers and malware pose an increasing threat to the security of telehealth systems.
There have also been a handful of high-profile fraud stories, with the most recent changes from just April 2019. Five telemedicine companies were allegedly part of a complex scheme in which healthcare providers convinced Medicare beneficiaries that they needed back, shoulder, wrist, and/or knee braces, regardless of medical necessity. They laundered the proceeds through international shell corporations, which were then used to buy cars, yachts, and real estate. With charges like these, it’s no wonder that providers may be reticent to invest in virtual care technologies.
2. New legal and compliance issues
As physicians add telemedicine services to their practices, they will need to consider the legal and compliance issues, from telemedicine-specific regulations, to Medicare coverage restrictions.
Licensure: As telemedicine has enabled providers to cross states to provide care, it raises licensing concerns; for the purposes of telemedicine, a physician is considered to be “practicing medicine” at the location of the patient. Therefore, it is critical for the provider to verify the patient’s location at the time of the consultation and ensure that they have the appropriate state license to provide the tele-care.
Prescribing: There are currently many restrictions on the use of telemedicine to prescribe controlled substances, especially given the U.S. opioid crisis.
Insurance coverage: Coverage for telemedicine varies widely.
Under Medicare, telemedicine is currently only covered if
The service utilizes real time, two-way, audio-visual telecommunications
The patient is at a qualified physician practice or hospital (with many in rural or remote areas)
The provider is credentialed and authorized for practicing telemedicine
The service itself is approved by CMS for telemedicine.
For Medicaid and private payor coverage, states have significant flexibility to decide whether to cover telemedicine and what, if any, restrictions they impose on the provision of telemedicine.
To better understand telemedicine technology installations across inpatient and outpatient facilities, and which ones are likely to purchase these solutions over the next six months, please request a free trial of Definitive Healthcare's platform.