At last month’s HLTH conference in Las Vegas, no matter what your burning healthcare issue was, there was sure to be a session or two that covered it. I was interested in telemedicine, and to judge by how often the subject came up over the course of the conference, I wasn’t alone. It feels like telehealth has been the next big thing for a long time now -- so why hasn’t it gotten more traction? Hoping for an answer, or at least some good hypotheses, I attended a session called “Telehealth’s Tipping Point,” which included speakers from Firefly Health, New York-Presbyterian, and the American Telemedicine Association.
All parties agree that telehealth adds value in the healthcare delivery system as an additional low-cost access point. That’s one reason employers have moved so quickly to implement telehealth – the hope that employees – especially those in high-deductible plans -- would use it to manage out-of-pocket spending, especially pre-deductible. And that all employees could benefit from the convenience of this alternative to an office visit (or even a trip to the ER).
So what are the obstacles to telemedicine adoption? According to the speakers, the biggest one might simply be the perception that “tele” medicine is not actually medicine. There are a few reasons people might feel that way. The interaction is electronic, rather than face-to-face. There may not be an established doctor/patient relationship. Sometimes communication is asynchronous; for example, during an email or text exchange. While these differences represent a significant departure from the traditional office visit, as successful telemedicine programs have demonstrated, they don’t equate to bad medicine.
Ultimately, the consensus was that telemedicine utilization will continue to grow and that the tipping point is not far off. It would help if regulatory environment supported provider access over state lines, to permit tighter integration across the provider spectrum. In addition, telemedicine providers can do a better job of acknowledging and addressing misconceptions about the effectiveness of the care they deliver. But employers really are key to moving telemedicine forward, by ensuring that it’s part of an integrated, continuous set of services. In our work with employers, we’ve seen that the more integrated telehealth is in the core delivery of care, the better the acceptance and overall outcomes. At the end of the day, “tele” should just be an indication of the communication modality, and not of the quality of care delivered. Medicine is medicine, after all.