Telehealth continues to surge in popularity despite flaws

Telehealth saves money and trips to the doctor's office, but can it also be a case of "too many chefs in the kitchen?"

That's what Chetan Mukudan, M.D., of Nashville's Heritage Pediatrics, says, according to an article in The Tenessean.

Telehealth services can result in a fragmentation of care where one medical professional is unaware what the other is doing, he says, especially in cases where telehealth replaces a trip to the pediatrician.

It's easy to count the advantages of telehealth--parents can get children a consultation anytime they need to, they don't have to take off work for a visit and doctors, in some cases, can prescribe drugs from minor infections and ailments after a telehealth visit.

But Mukudan says writing prescriptions based on a televisit is especially problematic.

"Fundamentally, I don't know what's going on with that patient until I really evaluate them," he says in the article. What patients describe and what the doctors see can be "vastly different."

"If someone is saying their ear hurts, you still can't look at (an) eardrum," Mukudan says. "If children have a sore throat, it doesn't mean they have strep. It could be viral."

Rich Novack, president and general manager for Cigna health insurance's mid-South markets, says in the article that telehealth is meant to be used to assess patients before going in for care.

But accountability and continuity of care is an issue, Mukudan said, with "lot of room for error."

Meanwhile, in an attempt to clear up some of the continuity issues, individual states continue to press forward with telehealth legislation, as evidenced by recent news out of Montana and a forthcoming effort in Florida.

Meanwhile, the Centers for Medicare & Medicaid Services last month announced that changes to Medicare's 2014 physician fee schedule would incrementally expand coverage for telehealth services.

Legislation introduced to Congress in December seeks to establish a federal definition of telehealth and clear up the confusion from myriad state policies. The bill, according to Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio), is based on legislation passed previously in California.

In addition, the Telehealth for Medicare (TELE-MED) Act of 2013 would allow Medicare providers to treat patients electronically across state lines without having to obtain multiple state medical licenses.

The number of patients worldwide using telehealth services will rise from less than 350,000 in 2013 to roughly seven million in 2018, according to a new report published by IHS Technology.

To learn more:
- read the article in The Tenessean

Related Articles:
Patients using telehealth services to hit 7 million by 2018
Bill attempts to clear up mishmash of state laws on telehealth
Why telemedicine is natural for the next generation of docs
Telehealth chronic disease self-management effective for boosting care to isolated areas
Global telemedicine market forecast: 18.5% growth rate through 2018

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