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Mobile images from professional cameras and smartphones

Are Mobile Images Good Enough for Telemedicine Consults?

Is a professional-level camera required for on-the-go telemedicine consults? The rise of healthcare using mobile devices—known as mhealth—is leading to questions about whether the images taken with smartphones can be trusted for accurate clinical diagnoses. Read more

Telemed doctor using tablet

Who Wants to Be a Telemed Doctor?

Patients in rural areas and with limited transportation may welcome telemedicine, but what about the doctors?

It appears that physicians everywhere are also embracing this technology. A recent nationwide poll, conducted by QuantiaMD and American Well, reveals that 57 percent of primary care physicians are interested and willing to conduct telemedicine visits with their patients (1).

To better understand this response, let’s examine the context. As revealed by the survey, doctors are spending increasing time on non-reimbursable phone and email communications with patients. The average family doctor devotes nearly 4 hours per week on phone calls and emails, and each phone call alone costs roughly $20 of the physician’s time.

In this situation, it makes sense to replace non-reimbursable activities with billable telemedicine hours. Read more

Schoolboy with sore throat

Telemedicine in Schools Makes It Harder to Play Hooky

With the rapid growth of telemedicine, missing school to see the doctor may soon be unheard of.

Thanks to a grant, Burke County Public Schools will implement Health-e-Schools program this fall. This initiative, offered by North Carolina’s Center for Rural Health Innovation, is being funded by a $701,207 grant from the Duke Endowment Grant Project.

The grant was earmarked for rural areas with less access to healthcare than urban regions. By introducing telemedicine in schools, the program will make it easier and faster for students to receive care. The goal of the initiative is to extend the reach of primary care physicians, rather than replace them. Read more

reimbursement for telemedicine

Medicare Falls Behind in Reimbursement for Telemedicine

You might think that the passage of the Affordable Care Act in 2010 and the resulting opportunities for telemedicine would have led to widespread telemedicine usage to increase access to healthcare while reducing costs, but the reality is that reimbursement from government agencies—such as Medicare—has fallen far behind the rhetoric. And when good intentions aren’t backed up with adequate funding, progress can become slower than molasses.

Telemedicine has certainly grown steadily, but the impact has been felt more significantly among those with private insurance that provides reimbursement for telemedicine visits. Among Medicare beneficiaries, less than 1% have coverage for telemedicine (1). And of those who are fortunate enough to enjoy such coverage, particularly those in rural areas, Medicare often requires the beneficiary to already be at a clinic. So much for making healthcare more convenient. Read more

Prioritize Patients

prioritize patients

I attended a webinar last week where the speaker, Jeff Robbins, Director of Neurodiagnostics and Telehealth at Tift Regional Medical Center, recounted the following (paraphrased) story:

Eight years ago Tift had purchased their first batch of telemedicine equipment.  For the first year or so they mostly stared at it, with no idea how to go about using it.

They wondered whether they could be reimbursed for anything they used it for and whether they could figure out how to use it and wondered what it could do.  They weren’t using their equipment.  They weren’t using telemedicine.

Then Jeff said they decided to “put the patients first.”  They purposefully forgot about reimbursement, coverage regulations, computer abilities of the doctors, or whether the possible uses fit into the business plan of the hospital.  They focused on finding out, through actually doing it, if telemedicine could help their patients.  When that happened…

All those things took care of themselves.

Or, as Jeff put Read more

5 Things I Learned on ATA’s This Month in Telemedicine Webinar

As with last month, this is largely geared to updates about legislation along with reminders about the upcoming Fall Forum conference in Palm Springs, CA, which I’ll have to consider as I live out Orange County.

This month’s takeaways are a little more subdued than last month which had some pretty big news (see here).  The ATA had just done a survey on online consultations and had over 500 respondents.

1)  45% of respondents are using telemedicine TODAY.  This is fantastic news and, in my mind, is possibly underreported because, as Mr. Linkous and Mr. Capistrant pointed out on the last call (and pointed out in our 3 Things from last month), nearly every institution is already using some form of telemedicine and the boards don’t realize it.

2)  Specialty Care and Behavioral Health were the leading segments.  Not terribly surprising, as specialty care often needs to use leading edge tools to leverage resources for special care, and behavioral health lends itself well to an old-school videoconferencing set up (patient and doctor meet via video), leading to less push-back on its use while providing maximum benefit to both patients and providers.  The industry will have to really work, I think, to make sure providers and CDOs are aware of the more specialized applications and the benefits to be had.  Telemedice will not yield a large harvest if we only pick the low-hanging fruit.  As if to prove that point:

3)  77% use video, 57% use audio and 28% use medical peripherals.  Just over a quarter are using peripherals, while three times that are using video.  Being at a video-primary solution provider: Yay!  Being a proponent of telemedicine as a whole: We can do better.  Even the video-primary medical solutions offer a lot of specialized or integrated offerings that provide more than just adding a visual element to distance care.  Again, the question is, how do we get this to the doctors and CDOs?

4) Of the 55% of respondents that replied they are not using telemedicine today, 75% plan to implement it very soon.  I present that as Exhibit A to the tipping point naysayers…although I concede that if you responded to a survey about telemedicine from the American Telemedicine Association, you’re probably already predisposed to an interest in telemedicine.  Having said that, interest in telemedicine has been on the rise, and 75% of that growing crowd being interested in giving it a shot can only be a good thing.

4)  Mr. Linkous pointed out something toward the end that I assumed would be a primary driver (or at least remove an obstacle) but assumed would take several more years:  Private insurance is increasingly taking the lead in pushing telemedicine.  I’ve been noting that the reduced cost/better outcome/reduced readmissions scenario HAS to eventually turn private insurance into champions of telemedicine.  Amongst the names he mentioned were Kaiser Permanente, Aetna, WellPoint, and others.

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