Telemedicine can be a tool for evaluating patients and providing subspecialty care to patients, as demonstrated in a recent study of a patient observed for post-concussion effects. Telemedicine care can deliver specialized treatment to patients, and is a way to bridge the distance gap between rural and urban trauma facilities.
In the study, the patient was observed via telemedicine 19 days after his concussion. Many different tests were performed, including a general neurological exam and a more targeted sport concussion test, which illustrates the level of testing and observation that can achieved via telemedicine. The patient was recommended a face-to-face visit with a concussion specialist and to refrain from physical activity due to the results of his telemedicine consultation.
Telemedicine may be a solution for doctors as well as patients. There has been a decrease in the number of students entering primary care, which will result in a nationwide shortage of 159,000 physicians by 2025. Hospitals can use telemedicine to remotely observe patients to help manage their inpatient population. Many facilities are reluctant to expand their telemedicine practices because most care delivered remotely is still not reimbursed by payers.
Effectively implementing telemedicine technology is the first step in achieving the best use of the technology. At an American Telemedicine Association meeting, a panel of experts offered suggestions to those considering implementing telemedicine. Careful planning prior to implementation was mentioned as more important to success than the technology itself. Determining the scenarios in which to use use telemedicine, in such cases as the concussion study, will require pre-planning to best serve patients’ health and save money for the facilities.
Medical professionals hoping to achieve use of telemedicine as part of their practice have encountered licensing issues to be a barrier to adoption. Doctors must be licensed in the state where the patient resides in order to treat them via telemedicine. Medical license applications are costly and require a waiting period. The Centers for Medicare and Medicaid Services’ carrier jurisdiction rule requires claims to be submitted to state administrative contractors for services rendered, which is another hoop for providers to jump through.
Patients have also been prevented by technology in trying to access telemedicine services. Poor Internet connection for either the patient or provider can prevent successful communication and observation via telemedicine. Providers must have the proper infrastructure in place to best treat their patients. Organizing facility data and upgrading Internet capabilities are part of infrastructural best practices.