Telehealth and health information technology are two of the biggest areas ripe for change given their importance to the Centers for Medicare & Medicaid Services, Dr. Barry Straube, the center's medical director, told an audience of more than 100 people attending FierceMobileHealthcare's executive breakfast focusing on telemedicine this morning. Straube, whose office is responsible for, among other things, national Medicare coverage decisions and regulations defining quality standards for healthcare facilities, believes the timing has just as much to do with Congressional approval as anything else.
"We've been given authority under the HITECH portion of the American Recovery and Reinvestment Act of 2009 to provide incentives for adoption of and meaningful use of electronic health records," said Straube, who was among five panelists at the event. "That's something that's very important for folks to understand; before we can do certain things, we need to have congressional authority to do so and, more importantly, the funding to do so."
Straube, echoing the sentiments of Dr. Adam Darkins, chief consultant for care coordination at the Department of Veterans Affairs and another panelist, said he still believes that more needs to be done to convince policymakers of the cultural change healthcare is going through. According to Darkins, the emphasis is moving away from care at brick-and-mortar buildings, especially with the increase in chronic conditions being treated.
"Like a factory...you brought the people, the capital and the resources there to once place," Darkins said. "That was probably appropriate when the majority of issues being dealt with were acute and life threatening, as opposed to now." Most people have chronic conditions, he said, where getting them into an institution for treatment isn't the issue, but deciding whether they need physical care in the first place is.
"The real challenge," Darkins continued, "is that healthcare organizations around the world are very much based upon the physical presence of a patient."
Straube though, was quick to point out that such a shift in thinking would be reliant upon "proved health outcomes."
"I think from the CMS perspective, if we're going to cover something, that something has to be reasonable and necessary," he said.