Healthcare reform, the newly insured and a growing interest in population health management are accelerating the market’s interest in telehealth technologies and services. Healthcare providers are developing integrated strategies for adopting these technologies with the goal of extending capabilities and patient interactions beyond traditional care settings. As more payers and employers begin to pay for telehealth services, the value of these tools is coming into focus. Market analyst IHS predicts the US telehealth market will grow from $240 million in revenue in 2013 to $1.9 billion in 2018, an annual growth rate of more than 50 percent, according to Forbes. Keys to the anticipated surge are the current physician shortage, an expanded patient base under the Patient Protection and Affordable Care Act and an effort to put consumers at the center of their own care.
Overcoming the obstacles
Historically, the healthcare industry has proceeded carefully in the world of digital advancements. High investment costs and uncertain return on investment have created a tenuous economic model. Healthcare providers also face three other key obstacles: uncertain reimbursement, varied state licensing laws and the potential for breaches in privacy and security.
Navigating reimbursement challenges
Reimbursement for telehealth services varies widely. Medicare pays for some services, especially in remote rural areas, but the program has several restrictions. It generally covers only services delivered “real time,” through videoconferencing, as opposed to “anytime,” through store-and-forward technologies.
Medicaid is the most common route states are taking to implement their telehealth programs. The National Conference of State Legislatures (NCSL) notes that to date, 43 states and the District of Columbia provide some form of Medicaid reimbursement for telehealth services.
Private payers need to comply with state regulations. Currently, 19 states and the District of Columbia require private insurance plans in the state to cover telehealth services, according to the NCSL. Arizona will join this list in January 2015. Nontraditional payers for telehealth services range from charitable organizations, long-term care and community health providers to self-insured groups and agencies serving special populations.
Policies continue to evolve. Several bills are before Congress to establish a federal standard for telehealth, while Medicare’s 2014 physician fee schedule will expand coverage incrementally for telehealth services.
Once again, HIMSS is asking for perspective about the value of Health IT. The organization asked members of the social media and blogging community to respond to this very question last year for its second year celebrating National Health IT Week. It’s doing so again in preparation of #HIMSS14.
As I pointed out last year, even though it seems like a simple question, there still don’t appear to be any simple answers. There remains different answers depending on who you ask. So, again, instead of offering my lone opinion, I’ve asked a variety of folks to respond to the question, “What is the value of health IT,” based on their insight and experience serving the space.
The value of health IT lies in its ability to address three of the major, although competing, forces of change in healthcare. The need to standardize care, personalize care, and reduce costs requires the synthesis of vast amounts of data as well as dramatic changes to workflow and process. I can conceive of no way to go about pursuing these changes without technology. The old adage “you cannot improve what you cannot measure” tells us that improving health care requires us to leverage our data, turning it into knowledge and to then build the new workflows that will change the way we deliver care.
Health IT is the means for providing the best possible data at the point of care. It addresses the who, what, when and where of a patient’s care, which helps healthcare providers enhance the patient experience and deliver high-quality of care to improve health and well-being, preserve privacy and ensure security. Health IT facilitates innovation and overcomes interoperability challenges that gives providers transparency for the patient pathway to improve quality of care and minimize clinical and financial costs by eliminating duplicate patient records, incomplete medical histories, incorrect medications, clinical errors, billing mistakes, and avoidable readmissions, as well as correcting the overuse, underuse, and misuse of beneficial care. Adopting health IT is the one strategy healthcare organizations can take to enter a golden age of patient care.