“[Telehealth] will be the way health care is provided. I don’t think we’ll call it anything. It will just be health care.”
Adam Darkins, VA chief consultant for telehealth services in reference to the future of telehealth (Calgary Scientific, n.d.)
I grew up in rural South Dakota. I couldn’t wait to move away, though ironically enough, I now find myself excited to return to my Midwestern roots. I will be moving to Nebraska this summer to work with a hospitalist team at Nebraska Medicine.
One of my passions is improving access to healthcare. In the Midwest, barriers to care include any of the common socioeconomical barriers, but can also include the mere distance to providers, battling weather conditions, or limited transportation options. Telehealth offers great promise in addressing many of these barriers. Much of healthcare involves conversation and education. These valuable discussions do not necessarily require a face-to-face visit to be effective.
“[Telehealth] has the same standards and the same outcomes as in person care delivery.”
Kyle Hall, Telehealth Coordinator at Nebraska Medicine (Calgary Scientific, n.d.)
Telehealth is defined as “the delivery of healthcare services at a distance using information and communication technology” (Calgary Scientific, n.d., p. 3). Telehealth and its necessary technology advancements are continually expanding across the nation, though many barriers still exist to its widespread and most effective use. Some of these barriers include widely varied regulation (currently different in all 50 states), reimbursement practices, eligible geographic locations, eligible services, and ability to practice across state lines (Calgary Scientific, n.d.).
However, telehealth, which was once just a subcategory of Health Information Technology (HIT), has beckoned attention from healthcare policy makers. The advisory board for Bloomberg Bureau of National Affairs (BNA) Health Law Reporter voted the topic as one of the Top Ten Health Law Issues for 2016 (Loughran, 2016).
In April 2014, Nebraska approved Legislation LB 1076 to expand the definition of telehealth to include synchronous and asynchronous, as well as remote patient telemonitoring (CCHP, 2014). The bill also declared that the reimbursement rate for telehealth is not dependent upon the distance between the healthcare provider and the patient (CCHP, 2014). These changes make Nebraska more progressive on the issue of telehealth expansion than many other states.
Later in 2014, Nebraska Medicine, formerly University of Nebraska Medical Center, received a $10 million telehealth grant from Centers for Medicare/Medicaid Innovation. This grant is being used to enroll patients in a remote patient monitoring program that will follow their care for 90 days post discharge and offer nurse coaching (Wilson, 2014). Remote patient monitoring allows a patient to use a mobile medical device to perform routine testing, such as check a blood glucose level, and send the results to a healthcare professional in real-time (Calgary Scientific, n.d.). The goal is to help patients stay healthy and out of the hospital rather than only treating them when they are sick (Wilson, 2014). Acting on these goals is necessary for quality, value-based, sustainable healthcare.
Over the coming months, this blog will explore many of the issues surrounding telehealth with consideration of existing health policy, technology advancements, impact of public and private sector institutions, ethics, and financing. A specific focus will lie on the advancements and future of telehealth at Nebraska Medicine.
Calgary Scientific. (n.d.). The road to telehealth 2.0 is mobile. Retrieved from http://cdn2.hubspot.net/hub/211730/file-2073190158-pdf/pdf/Telehealth-whitepaper.pdf?t=1452755174000&utm_campaign=Telehealth+Whitepaper&utm_source=hs_automation&utm_medium=email&utm_content=14892602&_hsenc=p2ANqtz-93M91Kw6w5okHfT-ebT4nWoiY2NC-o-EqhI_IsslNRG5olGUwbPP8TkFJv68LMhcVvL6bnFzvq-noBQFbo8Dy6t-qabQ&_hsmi=14892807
Center for Connected Health Policy (CCHP). (2014).NE approved legislation LB 1076. Retrieved from http://cchpca.org/ne-approved-legislation-lb-1076
Loughran, M. (2016). Telemedicine cracks top ten health law issue list for 2016. Bloomberg BNA. Retrieved from http://www.bna.com/telemedicine-cracks-top-b57982066002/
Wilson, T. (2014). $10 million telehealth grant awarded to med center. Retrieved from http://www.unmc.edu/news.cfm?match=15411.