Due to its digital nature it is often assumed that telehealth saves the health system money. However, the evidence to support this is varied. When conducting economic evaluations of telehealth services, the individuals evaulating them need to be aware of potential outcomes and extraclinical benefits of the telehealth service. Economic viability relies on the funding model within the country being examined (public vs private), the consumers willingness-to-pay, and the expected remuneration by the clinicians or commercial entities providing the services (examples of research on these topics from teledermoscopy in Australia ).
While laws about prescriptions issued via telemedicine consultations are stringent in many states, the general trend indicates more states will allow these types of online prescriptions, the Center for Connected Health Policy reported. A sticking point is that prescriptions require the establishment of a doctor-patient relationship, and some states do not qualify virtual visits as a legitimate relationship.
Telehealth Reimbursement Medicaid: According to Chiron Health, Medicaid systems in 48 states will reimburse for telehealth provided via live video systems while 19 state Medicaid programs will pay for RPM. 12 state programs will finance store and forward telehealth and seven states allow payment for all three telehealth categories. But even though Medicaid is more accommodating of telehealth than Medicare, rules governing payment through state Medicaid programs vary considerably. For instance, some states require patients to be in a medical facility and not at home while receiving telehealth care, and others require a licensed provider to be co-located with patients while they are receiving telehealth services.
Telemedicine involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation and a host of other clinical services that can be provided remotely via secure video and audio connections.
Video chatting has become ubiquitous with technology advances such as 4G internet speeds, low-cost smartphones and standardized phone operating systems. The advent of additional technology standards such as interoperable electronic health records (EHR), secure cloud storage (HIPAA), and wearable health trackers that can communicate with the smartphone has further incentivized consumers to jump on to the telehealth bandwagon. Perhaps the ultimate goal of telehealth is to bring continuous care to consumers while they are working or at home, years before they end up in a clinic.
There are many new medical tech terms being used today that the average patient may not be familiar with. For example, a common misunderstanding is that the terms telemedicine, telecare, and telehealth are interchangeable. The truth is that each of these terms refers to a different way of administering health care via existing technologies or a different area of medical technology. To clarify the subtle differences between these three terms, we have provided a detailed definition of each.
Telemedicine for intensive care unit (ICU) rounds: Telemedicine is also being used in some trauma ICUs to reduce the spread of infections. Rounds are usually conducted at hospitals across the country by a team of approximately ten or more people to include attending physicians, fellows, residents and other clinicians. This group usually moves from bed to bed in a unit discussing each patient. This aids in the transition of care for patients from the night shift to the morning shift, but also serves as an educational experience for new residents to the team. A new approach features the team conducting rounds from a conference room using a video-conferencing system. The trauma attending, residents, fellows, nurses, nurse practitioners, and pharmacists are able to watch a live video stream from the patient's bedside. They can see the vital signs on the monitor, view the settings on the respiratory ventilator, and/or view the patient's wounds. Video-conferencing allows the remote viewers two-way communication with clinicians at the bedside.
$49/visit or co-pay if not fully covered by health plan LiveHealth Online powered by AmericanWell / Vidyo has been picked up by health insurer WellPoint / Anthem. First piloted in 2013 in California and Ohio. WellPoint / Anthem began a mass rollout to several states in 2014 including Minnesota, Virginia, Kentucky, Maine…and most recently, Massachusetts.
We have collaborated with major hospitals like Max Hospitals, Fortis Healthcare, Global Hospitals, Medica Super Specialty (Kolkata), Pushpanjali Crosslay, Nova Specialty Hospitals, Artemis Hospital, Enhance Clinics and Delhi ENT Hospital among many others covering all parts of India. Should you need any treatment of any kind at a hospital, iClinic can facilitate this at a partner hospital and ensure that you get prompt, efficient and economical service.
Telehealth can also increase health promotion efforts. These efforts can now be more personalised to the target population and professionals can extend their help into homes or private and safe environments in which patients of individuals can practice, ask and gain health information. Health promotion using telehealth has become increasingly popular in underdeveloped countries where there are very poor physical resources available. There has been a particular push toward mHealth applications as many areas, even underdeveloped ones have mobile phone coverage.
The study of 15 of the state’s hospitals using the platform to treat some 500,000 patients saw a 25 percent reduction in a hospital’s staffing costs, while the hospitals saw a 20 percent increase in admissions – patients who would have been transferred to UMMC for ultimately non-serious issues, depriving the local hospital of revenues and taxing UMMC’s resources.
There are currently 29 states with telemedicine parity laws, which require private payers to reimburse in the same way they would for an in-person visit. As additional states adopt parity laws, private payers may institute more guidelines and restrictions for telemedicine services. Although it’s a step in the right direction, there is still uncertainty regarding reimbursement rates, billing procedures, and more.
In 1967 one of the first telemedicine clinics was founded by Kenneth Bird at Massachusetts General Hospital. The clinic addressed the fundamental problem of delivering occupational and emergency health services to employees and travellers at Boston's Logan International Airport, located three congested miles from the hospital. Over 1,000 patients are documented as having received remote treatment from doctors at MGH using the clinic's two-way audiovisual microwave circuit. The timing of Bird's clinic more or less coincided with NASA's foray into telemedicine through the use of physiologic monitors for astronauts. Other pioneering programs in telemedicine were designed to deliver healthcare services to people in rural settings. The first interactive telemedicine system, operating over standard telephone lines, designed to remotely diagnose and treat patients requiring cardiac resuscitation (defibrillation) was developed and launched by an American company, MedPhone Corporation, in 1989. A year later under the leadership of its President/CEO S Eric Wachtel, MedPhone introduced a mobile cellular version, the MDPhone. Twelve hospitals in the U.S. served as receiving and treatment centers.
One of the key advantages of telemedicine is the ability to provide healthcare to a patient, no matter the patient or provider’s location. However, since providers are licensed to practice in a specific state, they are only legally allowed to offer telemedicine services to patients in the same state. Currently, 49 state medical boards require physicians practicing telemedicine to be licensed in the state where the patient is located.
Through its agreements with insurers, Doctor On Demand stipulates what kinds of conditions its video consultations can cover, and which ailments and maladies require immediate medical attention. Increasingly, customers are taking advantage of the company’s mental health services — an area that’s grown 240 percent since it was introduced, according to Ferguson.
Telemedicine reimbursement is a difficult topic, especially with the constantly changing state policies. Many states now have parity laws which require private payers to reimburse for telemedicine visits the same way as in-person visits. The best way to navigate reimbursement is to call up your top payers and ask their policies. You can also check out our guide to telemedicine reimbursement and this helpful matrix from ATA on state policy.