By one estimate, 1.8 million patients will be treated via telehealth worldwide by 2017, a sign of the growing acceptance of remote medical services. But as with any emerging trend, there remains much to be worked out.
To that end, René Y. Quashie, senior counsel in the healthcare and life sciences practice at law firm Epstein Becker Green, writes in a blog post at Lexology of telehealth issues that should keep healthcare leaders awake at night.
Quashie has written previously that reimbursement--specifically restrictive Medicare policies--poses a significant barrier to widespread adoption of telehealth.
Other issues that should worry healthcare leaders, according to Quashie, include:
- Difficulties in complying with myriad state licensure and prescribing laws: Though a bill introduced in Congress last summer would have allowed VA providers to practice across state lines, that bill was not enacted. Most organizations find it difficult to comply with states' differing laws. Quashie also points to a Colorado doctor convicted in 2009 for prescribing an anti-depressant medication to a patient in California who later committed suicide. California law requires a face-to-face evaluation or first establishing the doctor-patient relationship. Such cases certainly put providers on edge.
- Lack of highly developed protocols and guidelines: The American Telemedicine Association is among those working to develop such standards--it recently released guidelines on remote mental health services--and Quashie lauds that. But, he says, physician, professional and trade organizations need to take the lead in developing best practices to overcome the skepticism of regulators and payers. Though the VA has been at the forefront of offering remote services, ATA CEO Jonathan Linkous has called the government overall a "lagging partner" in the move to telehealth.
- HIPAA privacy and security: Since technology resides at the core of providing remote services and records of it, there simply are more opportunities for patient information to be exposed, Quashie writes. He calls this the biggest threat to the future viability of telehealth.
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