For decades, telemedicine has long been associated with patients who are far, far away: Native Americans in Alaska, workers on oil rigs, scientists in Antarctica or astronauts in space. Numerous roadblocks-chief among them reimbursement, physician licensure, clinical workflows, infrastructure costs and unclear value propositions-have, for the most part, hindered telemedicine's advance into regular care delivery.
However, 2013 may be the year that the healthcare industry begins to move from isolated pilot programs to more widespread use of telemedicine.
It's not just that the technology is cheaper and easier to use, either. Washington, D.C. is taking notice. The Obama administration's healthcare reform law emphasizes coordinated, accountable care-in which telemedicine can play an important part-while proposed legislation from U.S. Rep. Michael Thompson (D-Calif.) would remove many of the bureaucratic barriers that hinder telemedicine's spread.
The American Telemedicine Association was formed in 1993, so CEO Jonathan Linkous isn't exaggerating when he says he's been waiting 20 years for this. "Healthcare is a late adopter," he says, "and it doesn't do anything without plodding, moving ahead and thinking about it."
Now is the time, he says, because the healthcare industry in the United States is undergoing "transformation." Healthcare reform, the needs of baby boomers, the growing challenge in treating chronic conditions and the sheer number of uninsured Americans leaves the industry at an inflection point, and telemedicine can accelerate this transformation. "It's not the answer, but the tool:hellip;to solving a lot of healthcare's problems."
Telemedicine Adoption Slow; Healthcare Cost Increases Fast
Those problems are well-documented. In 2012, the United States spent 18 percent of its GDP on healthcare, compared to less than 5 percent in 1950, and that's projected to rise to 30 percent by 2050. Meanwhile, roughly one-third of the $2.5 trillion spent in 2012 was wasted, thanks to a combination of fraud, red tape and duplicate tests.
Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology who spoke at the recent MIT Future of Health and Wellness Conference, says American healthcare is broken because the status quo works well for 75 percent of Americans-largely the healthy ones covered by corporate insurance plans-but is "substantially broken" for everyone else. The Affordable Care Act-which Gruber helped draft, along with the Massachusetts healthcare reform law of 2006-makes numerous strides to change this, with initiatives such as the accountable care organization and the health insurance exchange, but it's a process that requires humility and patience, he notes. (Few in Washington possess either characteristic, Gruber adds.)
For the most part, adoption of telemedicine has proceeded similarly. Case studies such as the Veterans Heath Administration, which uses telecommunications and home health monitoring technology to keep tabs on more than 50,000 patients and reports patient satisfaction levels of 85 percent, are the exception rather than the rule. The majority of telemedicine implementations, research firm Gartner notes in its Hype Cycle for Telemedicine, are pilot projects, and few have made it to a "self-sustaining state where costs are offset by reimbursements and the clinical value obtained."
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