Earlier this year, the Alaska state legislature passed House Bill 281, which allows a physician to prescribe drugs without a physical examination.In doing so, it opened the door to telemedicine, at least in remote areas.
As the name implies, telemedicine encompasses any medical activity involving distance. Today telemedicine, or telehealth, uses electronic information and telecommunications, but the practice goes back to the days when sea captains would use ship-to-shore radio to obtain medical advice.
Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which collect and transmit patient data for monitoring and interpretation. The Centers for Medicare & Medicaid Services (CMS) says, “…telemedicine seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site.” CMS views telemedicine as “…a cost-effective alternative to the more traditional face-to-face way of providing medical care (e.g., face-to-face consultations or examinations between provider and patient)…”
Telemedicine in Workers’ Comp
As telemedicine gains acceptance, look for it to play an increased role in medical treatment of workers’ compensation injuries. Telemedicine can help an injured worker get proper treatment sooner, particularly in remote or rural areas where medical help or specialists might be far away. In addition, telemedicine technologies deployed in ambulances can help speed diagnosis and the initiation of important, potentially lifesaving interventions.
Telemedicine has the potential to shave $4.28 billion annually from America’s healthcare bill, according to a study by the University of Texas Medical Branch. It offers these benefits:
- Providers get greater access to specialized information and diagnoses
- Reduction in hospital admissions from emergency departments
- Reduced wait times for outpatient consultation
- Increased productivity of healthcare staff
- Reduction in patient travel time and expenses
Telemedicine Offers Tremendous Cost Saving Opportunities
The University of Rochester Medical Center in Rochester, N.Y. has a telemedicine center. Its director, Kenneth McConnochie, MD, MPH, told a forum earlier this year that telemedicine can handle 85 percent of pediatric primary care visits and 40 percent of emergency room visits. The average telemedicine visit there costs $75, or one-tenth of the cost of a typical ER visit. They also save parents time and money.
The state of Georgia launched a telemedicine partnership in 2005 to provide better health services to the state’s large rural population, and to address a shortage of specialists. Paula Guy, CEO of the nonprofit Georgia Partnership for Telehealth, reported that a random sample of Georgia telehealth visits from 2011 saved the average patient travel time of 124 miles per encounter and a total of nearly $762,027 in fuel costs over 40,009 telehealth visits.
So why aren’t we seeing more providers racing to deploy telemedicine technologies? One word: money. Many private health insurers and Medicaid do not pay for telemedicine services, so physicians and health centers have little incentive to adopt them.
That’s too bad. Georgia requires payers (insurance companies and self-insured employers) to reimburse telemedicine services, but not all states have enacted similar legislation. Of the states that require payers to reimburse providers for telemedicine services, not all require them to reimburse at the same rate that they reimburse for in-person visits.
Revolutionizing Medical Care
The combination of sophisticated videoconferencing, electronic medical records, and telemonitoring can revolutionize medical care for all patients. The challenge lies not in the technology, but the processes and policies that govern healthcare delivery and payment.
Full integration of telemedicine into the workers’ compensation system will depend on the healthcare industry’s ability to address certain key barriers, especially insurance reimbursement models; concerns about liability in cases involving telemedicine interventions; and licensure rules that prevent healthcare providers from offering telemedicine consultations across state lines.