As the U.S. healthcare industry strives toward the apex of delivering the highest quality care at the lowest possible cost, we are adopting new ways to do things better, faster and cheaper.
Developing technologies that support telemedicine (also known as telehealth) could be one example.
Telemedicine is delivered by physicians, nurses and other care providers using various forms of web-based technology to interact with patients on screen versus in person. It typically involves videoconferencing, photo transmissions, remote monitoring of vital signs and other clinical services.
Telemedicine is a relatively new mode of healthcare delivery in Tennessee and in the U.S., though the number of patients worldwide using telemedicine services is estimated to rise from less than 350,000 in 2013 to about seven million in 2018, according to a 2014 report published by IHS Technology.
Healthcare organizations are also getting on board. According to a survey released by Becker’s Hospital Review last November, 84 percent of hospitals and health systems believe the development of telemedicine services is important to their organizations.
There are obvious advantages to a telemedicine encounter. For patients, it eliminates the time spent traveling and waiting, especially for people in rural areas where access to brick-and-mortar healthcare services may be scarce. More frequent physician-patient interaction and in-home monitoring solutions have the potential to speed up the delivery of care, help make sure patients adhere to treatment plans, better manage chronic diseases, and ultimately improve patient outcomes.
It also gives physicians who practice in rural parts of our state the ability to consult with specialists when patients are unable to travel to a referral appointment.
Critics raise valid questions about the quality, safety and effectiveness of a telemedicine encounter, including liability factors and appropriate access to and use of patients’ protected health information. Some physicians buy in to the concept. Others do not. Rules and regulations vary from state to state, with no federal legislation addressing the practice.
The Tennessee General Assembly in 1998 created a telemedicine license for physicians located outside of the state who used information transmitted electronically to diagnose or treat patients located within Tennessee. The “telemedicine license” is an alternative to a full Tennessee physician’s license. Last year, the Board of Medical Examiners proposed to eliminate the telemedicine license and require a “full” Tennessee license to practice telemedicine. It also seeks to define telemedicine, and place parameters and restrictions on its practice. The Tennessee Medical Association and others are actively participating in these ongoing discussions, advocating for rules that promote safety and accountability for each patient encounter, without being so restrictive that they stifle the technology’s potential.
To be clear, a telemedicine encounter is not the same as a face-to-face encounter with a doctor. Technology cannot replace that.
We should be open, however, to new technologies that can improve access to quality healthcare in Tennessee and, if used and regulated appropriately, contribute to better patient health and help reduce overall healthcare costs.
John W. Hale, Jr., MD, is President of the Tennessee Medical Association.