Yes, we’re perhaps a little late with this posting. However, we think the key takeaways (for us) from this year’s ATA (American Telemedicine Association) conference are important enough to immortalize anyway.
#1 We’re past the tipping point.
This was such a key point that the ATA itself made sure to quote a speaker mentioning it before the conference even started:
Speaker Joe Peterson, CEO of Specialists on Call, said: “In 2013 telemedicine started passing many ‘tipping points,’ in multiple industry segments, making it a true moment in time to found, scale, and invest. We’ve acted already on this basis, and we’re investing in growth more aggressively than ever.”
Jones Day/ATA Press Release for ATA 2014 Conference
Lest you think this is all without data and numbers, ATA CEO Jonathan Linkous added, “Today, 20 million Americans get some part of their healthcare remotely, and that number will grow as telemedicine expands its reach.”
Adding more evidence was ATA President Edward M. Brown, M.D. As reported by Jessica Taylor at Multibriefs:
Brown pointed out during ATA 2014 that remote patient monitoring now constitutes a $1.2 billion market globally, with 50 percent growth projected each year. He predicted that “within the next five years, more than 50 percent of healthcare delivery will be virtual,” further blurring the lines between telehealth, telemedicine, digital health, mobile health — and, quite simply, healthcare in general.
— Jessica Taylor, Why telemedicine is the future of healthcare, Multibriefs, May 22, 2014
Being past the tipping point has a few ramifications, the most important of which is takeaway point #3. Here in point #1, this means moving away from establishing a toehold of adopters with pilot programs to really educating providers and patients to efficiently use this technology. This in turn will increase utilization/adoption and fulfill the ultimate purpose of helping doctors keep us healthy. It also means that we solution providers should probably start helping healthcare professionals navigate the ins and outs of regulations and reimbursement strategies.
Now we covered this topic to some extant with Monday’s post, Mobile Bandwidth: A Consideration for Telemedicine and mHealth, so I won’t spend too much time on it right here. The typical situation, of course, is to find ways to better serve patients in rural areas. Driving the point home, I’d just attended a SAMHSA (Substance Abuse and Mental Health Services Administration) webinar on Tuesday where I was able to hear about the progress and obstacles of bringing healthcare, especially psychological, to service members and veterans living in places such as Alaska, Maine, and Montana. (swy|me, by the way, was chosen by River Edge Behavioral Health Center in Georgia for just such a purpose, and with a SAMHSA grant. Ali Yallah of River Edge spoke at the ATA conference about the experience.)
It’s highly important that telemedicine/telehealth/mHealth tools allow “field teams” to connect back to “home base” clinics or hospitals, and that solutions offer high-quality interactions—often to allow visual verification of whom you’re speaking with and what condition they are in—in difficult network conditions.
#3 “Who’s reimbursing me?” doesn’t matter (for now).
This may come as a bit of a shock. In fact, I’ll be shocked if you weren’t shocked. This is that “most important” ramification I referred to in point #1. Now that we are past the tipping point, with adoption increasing and resistance to the technologies reducing, the question everyone asks is, “Who is going to pay for this?”
There is very little legislation on this point, and what little there is varies from state to state. Insurance companies haven’t fully come to grips with it either, often charging for telemedicine consultations as out-of-network (when they cover it at all) despite the much reduced costs to all involved.
Waiting till the reimbursement question is ironed out is like building an ark when the wave has already hit the shore. Like Noah, wouldn’t you rather begin once you are convinced the rains are coming? It takes time to think through changes in policies and procedures and to implement technologies across multiple disciplines. So, may as well get started now, be up and running soon, and ride the wave as reimbursement begins to become commonplace.
The short-term benefits are sufficient to make it revenue positive or at least cost neutral:
- Decreased readmissions
- Improved patient access
- Non-clinical applications (e.g., registration kiosks or holding remote staff meetings)
- Concierge/pay-per-use care models
- Improved patient follow-ups
- Improved provider satisfaction
- Improved overall outcomes
We’ll be considering these bullets in greater detail over the next couple weeks. In the meantime, for those seeking additional information for telehealth reimbursement for their individual states, please visit ATA’s State Telemedicine Policy Center and the ATAwiki.