The Telemedicine Battle: when will the benefits outweigh the challenges?

Posted by Continuum on Jun 13, 2017 11:30:00 AM

Though telemedicine has been a segment of the healthcare industry for years, the use of telehealth technology has not expanded to meet its full potential. Telemedicine still has a few challenges to overcome, the biggest being the lack of strong financial incentives for implementation and utilization—despite telehealth’s capacity to lower overall healthcare usage and save time for providers.

Telemedicine female patient female doctor REDUCED.jpgThe healthcare industry lacks a unifying drive to incorporate telemedicine into physicians’ day to day routines, since in many states providers are not reimbursed for tele-visits at the same rate as in-person visits. Continuum Health's CMO, Dr. Michael Renzi, recently wrote on his difficulty embracing telemedicine due to a continuing need for fee-for-service payments. Though telemedicine offers great opportunities for practices, it is stymied by the lack of proper reimbursement.

Yet with the volatility surrounding healthcare policy under the Trump administration, there is hope that new or further developed healthcare legislation could incentivize telemedicine for providers, helping them to achieve the Triple Aim.

Increased continuity of care

As providers strive to administer high quality care at lower costs, some physicians have turned to telemedicine to assist with preventative care through virtual home visits and remote monitoring. Virtual visits allow the provider to maintain continuity of care for chronically ill patients, without sending a nurse to conduct an in-person home visit. Patients can use portable equipment and monitors to track vital signs and record health data remotely. The results can then be discussed over the phone or via web conferencing. These virtual visits are a convenient way for patients to communicate with providers, and they ensure continuity of care for the patient, while saving the provider time and improving patient experience.

Transitional care is also important after a patient has been discharged from the emergency room, and virtual visits are an effective means of monitoring the patient’s health so he or she is not readmitted. Telemedicine helps providers lower hospital readmission rates by maintaining ongoing communication with patients.

Using telemedicine to connect with patients is an efficient way of identifying and caring for patients with complaints that can be diagnosed and managed with minimal exams.1 By employing effective telehealth methodologies, providers can ensure that patients are not visiting or being readmitted to a hospital due to ailments that can easily be treated remotely.

Expanding the reach of providers and specialists

With an increase in telemedicine across specialties, patients are beginning to have more options for specialist referrals because location is no longer a limiting factor. Teledermatology, telepharmacy, and behavioral healthcare are just a few of the areas where virtual communication has proven to be quite successful, since there is a reduced need for in-person visits.2

Patients located in rural areas benefit greatly from telemedicine because they often do not have immediate access to providers. In 2003, the University of Mississippi Medical Center (UMMC) created a telehealth pilot program to link their specialists with rural emergency rooms. The program proved successful, and today the Center for Telehealth provides services across 30 specialties for most of the counties in Mississippi.3 Other networks are beginning to follow similar paths, but until telemedicine is widely embraced, progress will only be made on a network to network basis.

Drive down cost by lowering healthcare usage

In April, Continuum Health wrote on the opportunities primary care physicians have to lower the cost of healthcare. Telemedicine presents another opportunity to help drive costs down. According to a Sage Growth Partners report, “The cost of a video-based virtual visit is less than $50 and provides significant savings when compared to costs for similar minor medical needs treated at a doctor’s office ($80), urgent care facility ($160), or emergency room ($650)." 4 

By treating patients virtually, providers can lower their patient population’s overall healthcare usage. Implementing easily accessed, virtual lines of communication combats the rising costs from patients visiting urgent care centers and emergency rooms without consulting their primary care physicians. If telemedicine offers patients faster and more convenient access to their PCP, they will be more likely to engage with their provider through virtual channels. This engagement helps providers build quality relationships with patients, increase patient satisfaction, and lower the cost of care for patients and payers.

Challenges facing the future of telemedicine

In today’s healthcare environment, it is already a challenge for small practices to compete with hospitals due to the cost of maintaining an independent practice. Telemedicine could prove difficult for small practices to manage, since purchasing the necessary software can be costly. Even though telehealth software offers financial and strategic gains when incorporated into a practice, the initial purchase cost and implementation may prove to be a tall hurdle for independent practices. 

Within larger networks, telemedicine also poses challenges for providers. For payers, the ability to offer individual healthcare plans across state lines is a major benefit of telemedicine. Yet providers are licensed on a state by state basis, so they face difficulties virtually treating patients outside their state of licensure. However, this may change as more states enact legislation to participate in the Interstate Medical Licensure Compact (IMLC), which creates easier avenues for physicians to obtain licenses in multiple states.5 Many states in rural America participate in the IMLC, and hopefully as the Compact grows, the push for telemedicine will expand with it. 

Telemedicine offers a range of opportunities for providers to improve population health and increase patient experience. Yet until more states urge policymakers to draft legislation that further incentivizes telehealth, it may be forced to remain an underused but highly effective tool. 


1 How telemedicine can reduce emergency room visits  
2 Making the Connection: Is the telehealth market ripe for a boom?
3 Where telemedicine has been, where it's headed
4 Making the Connection: Is the telehealth market ripe for a boom?
5 Interstate Medical Licensure Compact

Topics: Telehealth, Telemedicine, virtual medicine

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