Studies show that the adoption of cost-saving telehealth services is accelerating in California and across the nation, and stakeholders are working hard to remove existing barriers.
A Growing Market
A study by Deloitte predicts that, in this year alone, providers will conduct 100 million e-visits globally, up 400% in video-based virtual visits from 2012 levels, with North America leading the way with a projected 75 million visits in 2014.
Experts say remote monitoring and other telehealth services help reduce hospital readmissions, improve adherence, clinical outcomes and patient satisfaction.
Kourosh Parsapour, MD, founder and faculty member at UC Davis Children’s Hospital, believes California is among the leaders in providing telehealth services.
Dr. Parsapour said UC Davis was among the first hospitals to use videoconferencing to connect hospitalized children with family and friends outside of the hospital, which has been shown to greatly reduce stress in children and likely shorten hospital stays.
Despite the expansion of telehealth, barriers to adoption remain, particularly in the areas of licensing, reimbursement and broadband access.
Cross-state licensing for doctors remains an issue with state medical boards requiring that a doctor who lives in one state and virtually visits with a patient living in another state be licensed in both states.
Reimbursing doctors for providing telehealth services also remains a sticking point.
As of March, 20 states and the District of Columbia have passed mandates for coverage of commercially provided telehealth services; 46 states offer some type of Medicaid reimbursement for telehealth.
Medicare has led the way in telehealth coverage for years, but private payers, who often look to the government program as an example, are slow to follow.
The Telehealth Modernization Act of 2013 (HR 3750) and two companion bills — HR 3077 by Rep. Devin Nunes (R-Calif.) and HR 3306 by Rep. Gregg Harper (R-Miss.) — aim to provide guidance to states looking to use telehealth, California Healthline reported.
HR 3750 currently resides with the House Commerce Subcommittee on Health.
Some people believe that California is ahead of the national curve.
More than two years ago, Gov. Jerry Brown signed the Telehealth Advancement Act of 2011 (AB 415) by Assemblyman Dan Logue (R-Linda), but some experts believe that the curve is still getting steeper.
Mario Gutierrez, executive director for the Center for Connected Health Policy, is reported to have said that while the passage of AB 415 held great promise that California would experience sweeping changes in the use of these communication technologies to deliver healthcare at all levels, this has not yet been the case.
The rollout for adequate broadband connectivity, particularly in rural and underserved areas, is also key for telehealth’s future expansion.
In California, the California Telehealth Network (CTN) joined forces with Oakland Children’s Hospital & Research Center and the Federal Communications Commission (FCC) to provide up to $400 million in annual funding to healthcare providers as part of the FCC’s new Healthcare Connect Fund.
The funding has spurred the development of broadband networks, linking urban medical centers to rural clinics in California.
CTN’s president and CEO, Eric Brown, wrote in CTN’s 2013 annual report that using the FCC and Rural Health Care Pilot Program broadband subsidy created broadband services at 121 locations statewide in rural and medically underserved urban communities.
CTN and UC Davis Health System also provided medical-grade broadband connections to more than 70 healthcare sites in 15 model eHealth communities, Brown noted.
Thus far, the Department of Veterans Affairs remains the leader in delivering telemedicine services with some 4,500 clinical video endpoints, linking 150 VA medical centers and supporting 90,000 veterans in their own homes.