One of these days governments, insurers and regulators are going to wake up to the fact that telehealth is an appropriate and cost-saving alternative to certain face-to-face encounters.
Aside from the use of telehealth technology to carry out on-line real-time video/voice communication between a provider and a patient (providing services to rural communities, services to restricted mobility patients, access to specialists, crisis response), telehealth also allows providers to fill time slots created by No Shows, reduce the number of cancellations due to weather/traffic and, in some cases, avoid the need for a face-to-face encounter.
There are many dimensions to telehealth, the least interesting of which is the scenario where a provider establishes a live video/voice connection and takes notes on paper. If we add to this a two-way data channel plus integration that allows consolidation of video/voice/data recordings at the patient EMR, efficiency increases.
The interesting point about the extension from two channels to three is that we now have off-line as well as on-line Portal capabilities – a provider can post a document that requires the attention of the patient to the Agency Portal without requiring that the patient be on-line. Patients can log into the Agency Portal 24 x 7 and request and receive certain services where the ‘provider’ is an auto-attendant.
The benefits do not end here . . .
During routine processing of patients along best practices care pathways, providers can use telehealth technology to reach out to peers, supervisors and domain experts to get “second opinions”, again, assuming integration that ensures that a copy of any outgoing “collaborative consultation request” is part of the documentation at the Point of Service and that any response(s) to requests post back to the POS.
Providers can also, from the POS, reach out to patients and either host a live telehealth mini-session or push out a context/situation appropriate form or document that the patient will see next time he/she logs into the Agency portal. If need be, rule sets can block further progress along the patient care pathway (e.g. a signed consent form must be in hand before a particular drug is prescribed).
Increasingly, we see telehealth being used to allow medical devices to upload patient monitoring information to data exchangers that can mine incoming data, highlight trends and refer evolving problems to the attention of providers.
As you can see, there is a lot of technology available but unless/until the technology is seamlessly integrated to patient processing and patient EMRs, many of the potential benefits remain elusive.
Currently there are several artificial constraints that limit the practical use of telehealth technology. Two of these are reimbursement practices and turf wars. Insurers need to work out a set of cost–plus rates for telehealth encounters. Regulators need to back off from “shooting themselves in the foot” policies where in one case a provider in one state can provide services to patients in an adjacent state but a provider in the adjacent state cannot.