Policy Issues in Telehealth The purpose of telemedicine is to remove distance as a barrier to health care. While telehealth is an accepted resource to bridge the gap between local and global health care, integrating telehealth into existing health infrastructures presents a challenge for both governments and policy makers (HRSA, 2011). Today there are policy barriers that prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns. Reimbursement Issues Reimbursement policies prevent the total integration of telemedicine into health care practice (Prinz, 2008). Today, there is no overall telemedicine reimbursement policy in the federal health care system (HRSA, 2011 & OAT, 2003). As a result, reimbursement for telecare has been limited and somewhat haphazard. It’s up to each state to specify what telemedicine services, if any, are eligible for Medicaid reimbursement (HRSA, 2011 & OAT, 2003). There are two policies which support telemedicine services. In 1997, the Balanced Budget Act (BBA) required that Health Care Financing Administration (HCFA) pay for some telemedicine consultation services to Medicare recipients. However, several administrative limitations restricted the effectiveness of this legislation. For example, patients had to be located in Rural Health Professional Shortage Areas (HPSAs). This meant that many patients had access to general practitioners but not to specialists, and store-and-forward consultations were excluded. In 2000, the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (S.B. 2505) sought to redress some of these limitations. For example, it reimburses a person for telehealt... ... middle of paper ... ...(2003). Telemedicine reimbursement report – HRSA. Retrieved March 30, 2011, from http://www.hrsa.gov/ruralhealth/about/telehealth/reimburse.pdf Prinz, L., Cramer, M. & Englund, A. (2008). Telehealth: A policy analysis for quality, impact on patient outcomes, and political feasibility. Nurse Outlook, 56(1), 152-158 doi:10.1016/j.outlook.2008.02.005 Telehealth connections for children and youth (2005).Telemedicine for CSHCN: A state-by- state comparison of medicaid reimbursement policies and title V activities. Retrieved March 30, 2011, from http://www.ichp.ufl.edu/documents/Telemedicine%20in%20Medicaid%20and%20Title% 20V%20Report.pdf Whitten, P. (2002). Telemedicine in Michigan: A policy report addressing legal and regulatory barriers. Retrieved March 30, 2011, from http://www.ippsr.msu.edu/publications/artelemedicine.pdf
Palmas, W., Shea, S., Starren, J., Teresi, J. A., Ganz, M. L., Burton, T. M., et al. (2010). Medicare payments, health care service use, and telemedicine implementation costs in a randomized trial comparing telemedicine case management with usual care in medically underserved participants with diabetes mellitus (IDEATel). Journal of the American Informatics Association, 17, 196-202.
With just a web camera and secure patient database to connect to a patient portal a doctor can view a patient’s records and send prescriptions and answer patient questions and concerns. The cost of Telemedicine is also less expensive than normal office visits and now insurance companies and Medicare cover the cost of this form of medicine.
I agree there is a great need to provide healthcare services in rural areas, and telehealth is a logical solution. As you mention, there are many barriers to implementing a successful telehealth program. Lack of connection to the internet, lack of cellular phone service, and lack of equipment, may be the biggest barriers. Foster and Sethares (2014), found in their integrative review of literature regarding telehealth acceptance and barriers in older adults that once a stable connection is established there are additional difficulties the elderly has with equipment. Older adult with chronic illness, have vision problems and dexterity issues that prevent use of computer technology.
Moffatt, J. and Eley, D. (2010). The reported benefits of telehealth for rural Australians. Australian Health Review. 34. 276-281.
Telehealth is the provision of Healthcare services through diverse technological methods from a distance (Hill & Miller, 2012). Clinicians can converse with patients through a myriad of options such as videoconferencing and email.
The article “eHealth” attempts to expand upon the conceptual framework proposed in article 1 by addressing the topic on a functional level. The author begins the discussion by providing the reader with a summary of the multiple definitions currently present in government, health and academia. The European Commission narrowly defines ehealth as the efficient use of technology in health care delivery (European Commission, 2003). The World Health Organization (WHO) defines ehealth as the cost effective and secure use of technology to advance health care, health education and research (WHO, 2005). The third and most inclusive definition was provided by The Journal of Medical Internet Research (JMIR); which defined ehealth as,
... teleadvice in the absence of a pre-existing patient-physician relationship - Systematic review and expert survey. Journal of Medical Internet Research, 2(1).
The new communication systems also give patients additional satisfaction as compared to the traditional techniques. Patients are delighted at the quality of communication services that come along with the program. As pointed out by one of the physicians at Colorado Permanente, the system is patient-centred and a real satisfier to them (Bishop et al., 2013). The positive feedback that is received from the patients is a clear indicator that the move towards adoption of the electronic communication services in the health sector is aimed at value creation for the
Specialists are using telemedicine to connect with patients and other providers that are in rural areas where it’s difficult to have a specialist onsite. For example, there are two hospitals in my area, one is 25mi away from where I
The idea of telemedicine is not new. In fact, when we get sick we often pick up the phone and discuss our conditions and possible treatments with our health care providers through the telephone. When there is an accident we dial 911 to obtain emergency assistance. These are just a few simple examples of applications of telemedicine. With advancements in technology, the new era of telemedicine will allow the patients and doctors to actually communicate both verbally as before but also visually. Telemedicine is broadly defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants".5 This technology has allowed people in underprivileged communities, rural areas, and geographically isolated locations to receive quality health care. However, the application of telemedicine is not limited to these regions. This tool will allow schools, hospitals, and other health care arenas to receive specialty care when needed.
In this article the author compared the changes observed with the use of Teletracking system for a duration of three years starting from 2013 in two different multispeciality chain of hospitals in Florida, the first being Health First, which is a fully integrated health system in central Florida with 900 beds distributed across four hospitals. Its flagship hospital is Homes Regional
In most of the rural health care settings, patients are prone to higher risk of illness due to the lack of proper diagnosis and care quality. This article has discussed the use of telemedicine in such health care settings for improving quality, increasing the time for patient physician interaction and for providing cost effective treatment. The goal of this research is to evaluate the stabilization time and to detect the psychological changes in the patients after using the CDSS. The study was conducted in four hospitals and the data was collected from the recognized websites. Only the retrospective data was collected for effective results. Consent form was signed from both the patients and the referral physicians. A randomization process was
These fiscal policies support the government to improve on healthcare systems and reduce the high and ever-rising costs of healthcare (Bloomrosen et al, 2011).The current investment in technological innovations within this sector such as the Health Information Technology (HIT) and Electronic Health Records (EHRs) ensures a cost effective approach to funding healthcare through initiatives such as the American Recovery and Reinvestment Act (ARRA), Health Information Technology for Economic and Clinical Health (HITECH) (Bloomrosen et al, 2011).With the EHRs legislation in place, healthcare providers have the capacity of prescribing medicine in a cost-effective approach (Orszag, 2008). Consequently, HIT ensures efficient provision of healthcare for the providers and hence reduces the expenses that come with healthcare delivery. Moreover, inadequate healthcare for consumers meant extra costs in terms of compensation for the damages and errors experienced.
E-Health, which is inclusive of Telemedicine and the use of Electric Medical Records (EMR), is a potential solution to the problems of accessibility, quality and costs of delivering public healthcare services to patients. Although e-health has become quite common in recent years, it remains unclear the degree to which clinicians are able to accept and use these new and rapidly developing technologies. The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate the predicted benefits (Zhang, 2015).
The gaps in use are mostly due to limited access due to low socioeconomic status, preconceived notions as to what can be done through the technology patients have access to and a racial divide. Educating patients as to why the use of these technologies is beneficial and useful will help to bridge some of that gap, but in order to bring more patients on board with technology access needs to be increased. At this time, there are free internet connections and computers at most, public libraries, but even that is not very convenient. Possibly devices and internet subscriptions need to be included in basic healthcare costs, although who would be responsible for paying these costs would need to be investigated. However, it is clear that most patients that do utilize or interact in some way with computer information systems in healthcare are satisfied with the