State policy a big factor in whether hospitals offer telehealth services

State policies have big impact on whether hospitals decide to offer telehealth services, according to research published in the newest issue of Health Affairs.

The research is based on data from the information technology supplement to the American Hospital Association 2012 Annual Survey of Hospitals, sent at the end of 2012 to all U.S. acute care hospitals.

It found that 42 percent of US hospitals have telehealth capabilities, and a number of factors affect whether those services are offered. Teaching hospitals, those equipped with additional advanced medical technology, members of a larger system and nonprofit institutions are more likely to offer telehealth services.

And it's not necessarily related to whether the organization uses electronic medical records, the study found.

"Our results suggest that telehealth is perceived as a way to increase patients' access to care and to give hospitals a competitive advantage," the researchers wrote.

Both the highest- and lowest-adopting states had fairly small populations and few reporting hospitals. At the top: Alaska, where 75 percent of the hospitals had telehealth; Arkansas (71 percent); South Dakota (70 percent); and Maine (69 percent). At the bottom: Rhode Island, with no hospitals participating in telehealth, and Utah with just 13 percent. The authors took that to mean that state policies were more likely to drive hospitals' decisions about offering telehealth.

State policies that required reimbursement at the same rate as face-to-face services made hospitals more likely to adopt telehealth. At the same time, states that required out-of-state providers to have special licenses for delivering telehealth services were less likely to offer that service.

"Our results suggest that states seeking to promote telehealth through reimbursement should focus on broad legislation instead of on paying for individual telehealth approaches, such as live video or store and forward," the authors wrote. They added that such legislation could enable hospitals to choose the type of telehealth that best suits their needs, which, in turn, would help with the success of such ventures.

The number of patients worldwide using telehealth services is expected to grow to roughly seven million by 2018, though some experts are warning that there are downsides that must not be overlooked--including malpractice and medical liability concerns.  

Lawmakers including Sen. Jon Thune (R-S.D.), however, recently applauded the Federation of State Medical Boards for efforts to find licensing solutions for multistate practice and advance telehealth itself.

To learn more:
- find the study's abstract

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