By Mark Terry
Recognizing that licensing and regulation has not kept pace with the growth of telemedicine applications, a new report offers five recommendations for the successful adoption of telehealth. The recommendations, made by the Information Technology and Innovation Foundation, a District of Columbia-based think tank, include:
- Adoption of a standard definition for telehealth: While a recently published study found there to be seven different federal definitions of telehealth, the report's authors stress that H.R. 3750, the Telehealth Modernization Act of 2013, can remedy that "by defining telehealth to include healthcare delivered by real-time video, secure chat, secure email or telephone." To be successful, however, the authors say it may be necessary for Congress to "impose penalties on the non-adopting states" if they do not adopt such standards within a two-year period.
- Establishment of a single, national license for telehealth providers: Most healthcare provider licensing is handled on a state-to-state basis, which significantly limits providers licensed in one state from offering telehealth services in another. A bill in currently Congress, H.R. 3077, the TELE-MED Act, would allow Medicare providers licensed in one state to provide services to beneficiaries in other states.
- Creation of technology- and location-neutral insurance policies: This would require Congress to modify Medicare reimbursement policies, as well as state legislatures to make changes to Medicaid and private insurance policies.
- Collaboration by state prescription drug monitoring programs: At the moment, numerous states have prescription drug monitoring programs, but not all states share the data. A national telehealth system would need these programs to communicate with each other, which would require format standardization. A Standards & Interoperability Framework initiative launched last fall by the Office of the National Coordinator for Health IT aims to create a common technical standard to allow prescription drug monitoring programs (PDMP) to share data with health IT tools used by providers for clinical decision support.
- Funding of research to boost quality and lower costs of telehealth programs: While growth of telehealth is moving quickly, it's important that what eventually becomes standard improves patient care and decreases the costs of healthcare practices.
A framework for evaluating telehealth programs must consider socioeconomic aspects--not just the technological--argue researchers in an article published online recently in Telemedicine and e-Health. Costs, benefits, barriers and outcomes, including clinical outcomes, are among the integral socioeconomic factors at play in telehealth implementations, they say.
Meanwhile, the American Telemedicine Association has suggested some changes to the Federation of State Medical Board's (FSMB) proposed regulation of telemedicine. Among the suggestions: Don't make remote consults more cumbersome than in-person treatment and clear the way for docs to practice across state lines.
To read more:
- read the report (.pdf)