Just a few weeks ago the U.S. Senate Subcommittee on Communications, Technology, Innovation, and the Internet, held a 2 hour hearing on “Advancing Telehealth Through Connectivity.” Stakeholders testified to lawmakers that telehealth is helping to achieve financial and care-related benefits, but still many barriers remain to widespread appeal and use.
In summary, industry experts from the U.S. Federal Communications Commission (FCC), informed the Senators that the use of telemedicine has both increased the quality of care by improving outcomes and, has reduced the cost of healthcare. This will provide a better experience for the patient. The telemedicine trend is still in infancy and there needs to be more changes to facilitate what is still an emerging use of technology.
The challenges today are still material and most importantly are:
• The amount in provider reimbursements
• The lack of interstate licensing
• The slow movement by the FCC in finding ways to reduce road blocks
• The expansion of high-speed internet access
The latter problem is not only an issue in what would be considered a rural environment, but also in very old and urban communities. Of the 4 key challenges, I believe the biggest issue is interstate allowance of medical care over the internet.
The problem is that each state and medical board sets the licensing of providers in said state. In our home state of Florida, only a physicians’ license under the law and medical board of Florida may legally provide medical treatment/service to a Florida patient. It is illegal today for the best doctor at the best institutions in the U.S., whether that’s in Massachusetts, Ohio, Pennsylvania or New York, to treat a patient in Florida if that doctor is not also licensed in Florida via telehealth (or telemedicine).
Last year the Florida legislature went about 99% through the process for it to die at the end. All that was required was for a reciprocity agreement to be valid with other states. As much as I love my state of Florida, I cannot believe that our requirements in Florida are any better than Massachusetts, Ohio, Pennsylvania or New York. For one they have been training doctors in those states far longer than we have here, some by 200 years or more. University of Pennsylvania 1765, Columbia University (Kings College) 1791, Harvard 1782, and University of Cincinnati 1819. The oldest medical school in Florida was chartered in 1952 at University of Miami.
Politico.com reported the hearing this way –
BROAD SUPPORT FOR MEDICARE EXPANSION AT TELEMED HEARING: Things are looking up for telemedicine after an unpleasant last week on the Hill. At a Senate Commerce subcommittee hearing yesterday more than a dozen senators spoke out for increased use of the technology, and most of them said Medicare ought to pay for some of the expansion. “Innovative markets, including in mobile technology, could be unleashed if Medicare were to step out and reimburse more extensively for telehealth services,” said Hawaii Sen. Brian Schatz, the top Democrat on the subcommittee. Subcommittee Chair Roger Wicker (R-Miss.) said he would reintroduce legislation he filed last year to expand telemedicine payments for use in all critical access hospitals and in other venues. The two-hour hearing followed last week’s gloomy news that the House Energy and Commerce Committee planned to drop telemedicine from the 21st Century Cures package, due to the lack of definitive evidence it will save money. But supporters were bolstered by Tuesday’s session, where newbie senators like Schatz, Peters, Cory Gardner (R-Colo.) and Cory Booker (D-N.J.) backed it. “The resounding bipartisan support for expanding reimbursement for care provided to Medicare beneficiaries echoes the support in the House of Representatives,” the Alliance for Connected Care said in a statement. “We hope Congress will move forward expeditiously to ensure Medicare beneficiaries have the same access to telehealth and remote patient monitoring as patients in the commercial marketplace.”Pros get the whole story here: http://politico.pro/1DMgq2q
To provide a mechanism to help the states get together, we strongly believe that the solution has to come from Washington. Furthermore, Medicare has to begin to recognize this as a valuable way to provide care, allow for more widespread use of telemedicine and pay for it. The value that will be created will be material. We have the technology today for all U.S. doctors to have electronic medical records (EMR) that include a patient portal and communication (Meaningful Use phase 2); hence, the priority to integrate telemedicine in the next major enhancement of EMR.
– Noel J. Guillama, President