Time To Treat Telemedicine as Just “Medicine”

Over the last year or two, hospitals and clinics have shown a steadily growing interest in offering telemedicine services. Certainly, this is in part due to the fact that health plans are beginning to pay for telehealth consults, offering a new revenue stream that providers want to capture, but there’s more to consider here.

Until recently, much of the discussion around telehealth centered on how to get health insurance companies to pay for it. But now, as value-based purchasing becomes more the norm, providers will need to look at telemedicine as a key tool for managing patient health more effectively.

Evidence increasingly suggests that making providers available via telemedicine channels can help better manage chronic conditions and avert needless hospitalizations, both of which, under value-based payments, are more important than getting a few extra dollars for a consult.

Looked at another way, the days of telehealth being a boutique service for more-sophisticated consumers are ending. “It’s time to treat telemedicine as just ‘medicine,’” one physician consultant told me. “It’s no different than any other form of medicine.”

As reasons for treating telehealth as a core clinical service increase, barriers to sharing video and other telemedical records are falling, the consultant says. Telemedicine providers can already push the content of a video visit or other telehealth consult into an EMR using HL7, and soon information sharing should go both ways, he notes.

What’s more, breaking down another wall, major EMR vendors are offering providers the ability to conduct a telehealth visit using their platform. For example, Epic is offering telemedicine services to providers via its MyChart portal and Hyperspace platform, in collaboration with telehealth video provider Vidyo. Cerner, which operates some tele-ICUs, has gone even further, with senior exec John Glaser recently arguing that telehealth needs to be a central part of its population health strategy.

Admittedly, even if providers develop a high level of comfort delivering care through telehealth platforms, it’s probably too soon to rely on this medium as an agent of change. If nothing else, the industry must face up to the fact that telemedicine demand isn’t huge among their patients at present, though consumer plays like AmWell and DoctoronDemand are building awareness.

Also, while scheduling and conducting telemedicine consults need not be profoundly different than holding a face-to-face visit — other than offering both patient and doctor more flexibility — working in time to manage and document these cases can still pose a workflow challenge. Practical issues such as how, physically, a doctor documents a telehealth visit while staring at the screen must be resolved, issues of scheduling addressed and even questions of how to store and retrieve such visit records must be thought through.

However, I think it’s fair to say that we’re past wondering whether telemedicine should be part of the healthcare process, and whether it makes financial sense for hospitals and clinics to offer it. Now we just have to figure out where and when.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

4 Comments

  • I’m responding more as a technologist and consumer advocate than a health professional, and while I’ve published dozens of telehealth articles (http://www.mhealthtalk.com/?s=telehealth), I’d like to comment on two specific telehealth benefits.

    CONVENIENCE – By making access to care more convenient – from home, school, work or while traveling any time of day or night – telehealth can greatly help reduce the cost of care by finding and treating conditions earlier and without the need for travel or taking time off from work.

    CONTEXT – Patients often show anxiety when visiting a clinical setting, thus effecting their vital signs and what practitioners can notice, but remote monitoring lets them keep closer tabs on conditions and provides a truer sense of context, such as how blood glucose is directly affected by foods consumed, exercise, sleep, and other things going on in the patient’s life.

  • Wayne,
    Thanks for adding to the conversation. Some great points. One challenge I’ve always had with telemedicine is that it’s more convenient for the patient, but not the doctor. I think that’s one big reason why it’s not more highly adopted. It’s important to remember both sides of the equation.

  • This particular post on Telemedicine along many others regarding products/services developed within the HIT sector I have seen posted previously, and so note once again these completely ignores a significant aspect that involves the use of any of what I’ve seen presented or discussed in this blog site. Below I have excerpted from the NC Medical Board [with links to sources] the current position/opinion they hold around some of the technology use that is ‘proposed and lauded highly’ in your blog posts. Most physicians are not interested in having their License to practice medicine suspended, restricted or having publically posted disciplinary actions against them by their state Medical Board. Feel free to contact me via my email if questions on this. The physician-patient relationship [ last Amended: Sep 2016]
    It is the Board’s position that it is unethical for a physician to allow financial incentives or other interests to adversely affect or influence his or her medical judgment or patient care. Patient advocacy is a fundamental element of the patient-physician relationship and should not be altered by the health care system or setting in which a physician practices. When economic or other interests are in conflict with patient welfare, the patient’s welfare must take priority.
    http://www.ncmedboard.org/resources-information/professional-resources/laws-rules-position-statements/position-statements/the_physician-patient_relationship
    Contact with patients before prescribing [last Amended: Jun 2015]
    ‘ …this will require that the licensee perform an appropriate history and physical examination, make a diagnosis, and formulate a therapeutic plan, a part of which might be a prescription. This process must be documented appropriately.’
    ‘It is the position of the Board that prescribing drugs to individuals the licensee has never met based solely on answers to a set of questions, as is common in Internet or toll-free telephone prescribing, is inappropriate and unprofessional.’
    http://www.ncmedboard.org/resources-information/professional-resources/laws-rules-position-statements/position-statements/contact_with_patients_before_prescribing

    § 90-14. Disciplinary Authority.

    ‘ The Board shall have the power to place on probation with or without conditions, impose limitations and conditions on, publicly reprimand, assess monetary redress, issue public letters of concern, mandate free medical services, require satisfactory completion of treatment programs or remedial or educational training, fine, deny, annul, suspend, or revoke a license, or other authority to practice medicine in this State, issued by the Board to any person who has been found by the Board to have committed any of the following acts or conduct, or for any of the following reasons:
    [you should read this section in its entirety as it encompasses the legal authority granted to the NC Medical Board re: licensure & the practice of medicine in this state,
    however ** read especially carefully what is stated within: # 6 & #12]
    http://www.ncga.state.nc.us/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_1.html

  • L Faith,
    I’m not seeing the connection between this and telemedicine. I think you can do telemedicine and meet the requirements you outline without any problem.

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