AAFP panel: Telemedicine can help expand care

Telemedicine offers a way for doctors to treat more patients as the Patient Protection and Affordable Care Act brings in more people seeking care. And the quality of care is not compromised, panelists told a recent forum hosted by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in Washington, D.C.

"Telemedicine is not different medicine," said Jason Mitchell, M.D., director of the American Academy of Family Physicians' Center for Health IT. "It's a different interaction."

Patients say they value having to take less time off work, less travel and greater convenience, according to an AAFP article.

For example, The Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) program at the University of Arkansas for Medical Sciences in Little Rock, Ark., provides a consulting service for the state's physicians.

In a state where 73 of 75 counties are designated as medically underserved, patients can be "seen" remotely through videoconferencing technology, and if a problem is found, referred to the Little Rock facility. If they must hear bad news, they're closer to home and family and friends, Curtis Lowery, M.D., professor, chair, and maternal-fetal medicine director of the program, said.

The University of Rochester Medical Center touts its Health-e-Access Telemedicine Program for a 22 percent reduction in ER visits among schoolchildren. Telemedicine visits cost on average $75 compared with $750 for a typical ER visit.

And telehealth is enabling 90,000 veterans with a chronic condition to live independently, according to Adam Darkins, M.D., chief consultant for telehealth services at the U.S. Department of Veterans Affairs (VA).

Telemedicine requires technical support and training, the panelists stressed, and developing relationships is paramount.

A bundled payment system, rather than fee-for-service reimbursement could make telemedicine more effective. A Health Affairs study this week noted that state policies on factors such as reimbursement and licensure are central to hospitals' decisions to offer telemedicine services. A second study found telemedicine expanding the patient pool.

And Stanford medical student Akhilesh Pathipati wrote recently that it's a natural method of communication for a new generation of doctors.

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