Telehealth. Almost everyone agrees it has great potential to improve the outcomes and the savings for health and human service systems (see From Telehealth ‘Pilot To Prediction’). Protectionist lobbying is all too common (see Texas Doc Board Votes To Restrict Telemedicine Visits). Enabling legislation is spotty but growing (see Telehealth Legislation – Filling In The Crazy Quilt). But adoption lags (see The Road To Telehealth Adoption: One Step Forward & One Step Back).
So what does this look like on the ground? A recent Associated Press article about the telehealth situation in Idaho, Telehealth Benefit To Idaho’s Rural Mental Health Patients, illustrates the very uneven market situation we find in most states. According to the story:
- There is a shortage of psychiatrists and mental health professionals – According to the Idaho State Board of Medicine, out of 7,000 physicians licensed to practice telemedicine in Idaho, only 100 are psychiatrists.
- There have been and continue to be regulatory issues – After suffering a steady stream of doctor shortages and out-of-state licensing conflicts, the state was faced with an immediate crisis when the largest telemedicine provider in the U.S., Teledoc, stopped doing business in Idaho (see Doctor Who Prescribed Antibiotic By Phone Could Lose Certification). The state responded with legislation mandating new telemedicine rules from the state’s medical licensing boards, leading to the new Idaho Telehealth Access Act, which was proposed in February and signed into law in March (see Idaho House Bill No. 189 – Idaho Telehealth Access Act). The legislation requires all telehealth to be consistent with the licensing and standards of the medical profession, defines how the patient-provider relationship may be established, and limits prescriptions that can be authorized via telehealth (see Arkansas, Idaho Pass Bills That Allow Limited Telemedicine Use).
- A move away from fee-for-service pushes the adoption of telehealth in the realm of managed care – In 2013, the Idaho Department of Health and Welfare hired Optum Idaho to manage the state’s Medicaid nonhospital mental health services, and Optum has been helping provider organizations use telehealth for mental health issues and substance abuse recovery – “According to Optum, roughly 1,000 patients accessed help via telehealth in 2014 through 15 providers.”
- The consumer perception is generally very positive – Telehealth consumer Jennifer Griffis was quoted as saying, “We need to be able to have these services available, even if it’s not the traditional way, we can’t just be stuck.”
- There is the acceptance (and positive response) of clinical professionals to practicing on-line once they try it – William Hazle, a Boise psychiatrist, is quoted as saying, “I would never have pictured this in the 70s, but now it’s almost entirely what I do.”
Despite the uneven adoption and relatively poor integration of tech-enabled services into most provider organizations’ clinical workflow, over the last two years, consumer online virtual care has more than doubled, and payers are expanding telemedicine and e-health of various types (see What Government Telehealth Opportunities Are Out There?, Telehealth Reimbursements 2014: Medicaid, Telehealth Reimbursements 2014: Health Plans, and Telehealth Reimbursements 2014: Medicare). And, the telehealth market in the U.S. is expected to grow from $240 million in revenue in 2013, to $1.9 billion in 2018 (see Building A Sustainable Telehealth Program).
Each passing year, telehealth moves toward the proverbially tipping point (see Preparing For The Telehealth Tipping Point and Where Are We With Telehealth? Does The Snapshot Tell The Story?), and managers of provider organizations will eventually (sooner in some geographies than others) have to consider integrated tech-enabled services into their operation due to consumer preference, managed care, pay-for-value, and competition. For more on positioning your organization for possible future telehealth requirements, or to expand on the success of your current service lines, make sure to join the OPEN MINDS team for the session, Building A Sustainable Telehealth Program: Learning From The Experiences Of Executives Who’ve Been There, at The 2015 OPEN MINDS Technology & Informatics Institute.