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Telehealth/ Telemedicine: An Overview

Written by: Kelly Buckman
  • An elderly woman living alone with limited mobility dials into a teleconference to receive physical therapy via digital monitoring
  • A new mother living in a remote rural area dials into a tele-session to receive assistance with breastfeeding
  • Two physicians 1200 miles apart meet over video conference to review a patient’s X-rays.
These scenarios are all examples of ways Telehealth is used in the modern age. Telehealth is most commonly defined as “the distribution of health-related services and information via electronic information and telecommunication technologies” (www.hrsa.gov). The terms ‘Telehealth’ and ‘Telemedicine’ are often used interchangeably, but there are subtle differences, in that telemedicine involves using telecommunication and information technology to provide clinical health care whereas ‘Telehealth’ is a broader term encompassing non-clinical (i.e., administration and provider education), as well as clinical implications.
It may surprise you that telehealth as a concept is not new or even a 21st century invention. The earliest documented use of telehealth goes back to 1876, when Alexander Graham Bell used his early telephone to call his assistant Mr. Watson for help when he spilled acid on his pants. Not exactly high tech by our standards, but it was back when the telephone was a newfangled technology. Later on, telemedicine capabilities were built into early spacecraft as well as the first spacesuits.
Today, the use of portable devices such as laptops and mobile devices make telehealth more prevalent than ever before. What’s more, as the infrastructure and technology advances, telehealth becomes more accessible to hospitals and healthcare providers.
Certainly, telehealth presents many benefits, including providing the opportunity for quality healthcare to those who might otherwise find it out of reach, as well as assisting healthcare providers with diagnostics. Telehealth is ideal for patients living in remote areas where specialists are not available. Remote patient monitoring allows patients to stay at home longer and avoid unnecessary hospital time. The result is less of a burden on the patient and the healthcare system. Uses of telehealth in the 21st century include:
  • Primary Care
  • Specialist referral services
  • Remote patient monitoring
  • Consumer medical and health info
  • Medical education
But for all the benefits offered by telehealth, there are downsides to this enhanced use of technology in healthcare, including:
  • the additional cost of telecommunication and data management and of technical training for healthcare providers and staff who use it.  
  • the decrease in human interaction between healthcare providers and patients.
  • Treating patients through virtual interaction may decrease time efficiency in situations where the patient or the provider or both are unfamiliar with the technology.
  • Perhaps more concerning is the risk of HIPAA violation due to PHI/PII being compromised.
Adding to providers’ concerns, telehealth may not be covered under Medicaid requirements in the same way that in-person care would be. However, individual states have some flexibility in determining whether to cover telehealth and what types to cover.  Medicare coverage has been more restrictive. Currently, Medicare will reimburse for telehealth services only for specific services delivered via live video. However, each year, the US Dept. of Health and Human Services considers requests for coverage of new telehealth services.  Although policy makers have not always been quick to accept telemedicine, there are bills in the works that could greatly increase adoption by payers, patients, and providers.
For many healthcare providers, the cost of telehealth may be more than offset by the ability to provide patient care more efficiently, thus saving money in the long run. A recent study found that the average cost of a doctor’s visit is $43 in lost time, in addition to the medical bill. Saving patient’s time and the cost of commuting is a big win for patients, especially if they have a chronic condition that requires repeated visits.  Also, with the widespread use of high tech devices such as smart phones and tablets, the adoption of telehealth software is much less expensive and complex than it once was.
Lack of in-person interaction between provider and patient is certainly a valid concern, and physicians will need to weigh this factor against the benefit of being able to check in with a patient remotely and answer questions about medication quickly and conveniently, which may help them adhere to their treatment plan. For many healthcare providers, the ideal plan may be a mix of both in person care and telehealth, depending on a patient’s preference and circumstances.
In terms of risk of violating patient privacy regulations, the Health Information Technology for Economic Clinical Health or HITECH Act of 2009 provides for enhanced privacy and security requirements.  When patients and healthcare providers connect virtually, telehealth providers are required to guarantee the same level of privacy they would in their physical office. There are HIPAA encrypted telehealth systems, although CMS does not regulate the use of telecommunication platforms.
It’s expected that the global telemedicine market will grow at a compound annual growth rate of 14.3 percent between 2014 and 2020 (per a Nathiel Lacktman, Esq. Healthcare Partner, Foley & Lardner report). Market value is expected to reach $36.2 billion by 2020, an increase from $14.3 billion in 2014 according to the report.
According to the State Health Telehealth Laws and Reimbursement Policies Report of April, 2016, in 2015, 42 states proposed a total of more than 200 pieces of legislation having to do with telemedicine. The report also notes that 29 states and the District of Columbia have laws mandating that health plans cover telemedicine services.
Despite the rapid growth of the market, advances in technology, legislative support, and an increase in payer reimbursement, in the end the interaction between patients and providers is a personal one. Ultimately, proof of efficacy, and convenience will not supercede personal preference, and it will up to be the patient and the provider to decide in which instances it is appropriate to meet via an electronic platform, or in a traditional Doctor’s office.
Note: Barracuda Consulting is experienced in implementing telehealth solutions for medical practices. We provide consultation, guidance, and turn-key telehealth solutions to increase revenue efficiently, and provide greater access to care while utilizing state-of-the art technology.
Please leave your questions or comments below. Or, if you would like to employ our telehealth consulting services, please contact us.
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Kelly Buckman is a healthcare IT expert and field expert blogger for Barracuda Consulting.
Kelly has almost a decade of experience as a Technical Support Engineer/ Analyst in the field of Healthcare IT, over 20 years in IT Support, and several years of experience in Project Management. She has a B.A. from Mount Holyoke, Masters degree from UMass Amherst, and lists her skills as the ability to analyze and resolve various types of application, server and network issues, and to communicate complex ideas effectively.
She is also the mother of 3 sons, ages 19, 17, and 11, lives in western Massachusetts, and enjoys solving puzzles, reading, and travelling.

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