Guide: Telemedicine benefits held back by lack of reimbursements
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The American Telemedicine Association Annual International Meeting & Trade Show will host an estimated 6,000 providers, payers and other health care leaders May 5 to 7 in Austin, Texas. In this two-part interview, ATA President-Elect Ed Brown, M.D. founder and CEO of the Ontario Telemedicine Network, sat down with SearchHealthIT to preview what attendees can expect from this year's meeting and to discuss how telemedicine can potentially play a part in accountable care organizations' reshaping of U.S. health care, as well as other telemedicine benefits. See our American Telemedicine Association (ATA) 2013 conference guide for more meeting coverage. View part one of the interview here.
How should telemedicine be integrated into new "accountable care" models in the U.S.?
Brown: There are a lot of different models out there, but some of the most obvious ones are when you're looking after patients with significant chronic diseases, like congestive heart failure or chronic obstructive pulmonary disease. These are patients that can benefit tremendously from an appropriate telehomecare model. It can not only improve their health care, improve their outcomes, improve their satisfaction, but at the same time reduce their hospitalization rates and their hospital emergency room visits. So it's really a win-win all around. In a situation where one organization is responsible for both the quality and cost of the health care, clearly telemedicine is a viable solution.
Is there an equivalent to accountable care organizations (ACOs) in Canada that you're familiar with?
Brown: Canada's health care system is a little different. We have a single payer in each province that insures the services and funds all of the different health care organizations. But then almost all of the organizations are independent -- independent hospitals, primary-care facilities, specialists -- so there isn't really an equivalent at a large-scale yet of something similar to the ACO model.
Which patients and where are best served by telemedicine?
Brown: At the end of the day, telemedicine is the use of technology to enable and improve health care, and that can be for our sickest patients with chronic illness using telemedicine in their homes, or healthy people who need to connect with their physician or other provider from their office and just want the convenience.
As of right now, which telemedicine services are being most widely implemented?
Brown: I think if you had to pick one service that is maybe the most ubiquitous in telemedicine, I would say teleradiology and also telestroke services. I think it's almost becoming the standard of care that if a stroke patient arrives at a hospital, you need to be able to decide whether to give that patient tPA [tissue plasminogen activator], a clot-busting drug. If you don't have the expertise on-site, then you need a remote teleneurologist, and I think that is probably one of the biggest applications right now across the country.
How often are telemedicine services used for physician education, as opposed to patient care?
Brown: That's a huge application. I know in our particular network, we had about 14,000 education events across the province last year. It's very popular. The education is a way of diffusing best practices out of the academic center, and helping spread that information out to folks who aren't as close to the academic centers. It's also a great way to connect people with each other, and certainly it's a way to make people familiar with the technology, which makes them more comfortable using it for clinical care in the future.