Dr. Charlie Miraglia is the Chief Medical Officer at hc1.com.
In the 1997 Sci Fi film base on Carl Sagan’s eponymous novel Contacte, Ellie Arroway, the protagonist played by Jodi Foster, spends her life waiting to make first contact with extraterrestrial life. In today’s healthcare world, making “first contact” with a doctor, nurse, or other provider “over the airwaves” is no longer the stuff of science fiction – it’s called telemedicine and it’s already here.
Telemedicine can be defined simply as the delivery of care over a distance in real-time, using telecommunication and information technologies. It was first developed to help improve access to medical services that might otherwise be difficult to achieve because of geography, such as in distant rural communities. It is also used in emergency situations to save lives, and more routinely to remotely monitor a patient’s condition on a regular basis via transmission of medical, diagnostic, and analytic data from one site to another.
The availability of telemedicine varies widely from state to state, due in part to the variability in reimbursement coverage for these types of services. Currently in the U.S., only 28 states and the District of Columbia require payers to cover telemedicine services at the same rates as “face-to-face” services. In 2014, Medicare reimbursement for telemedicine was less than $15 million and in 2012 it was only $5 million. However, the future looks bright for telemedicine and all of its potential applications – last year the telemedicine market was valued at almost $18 billion.
The same challenges that are driving healthcare in general - a growing number of insured, an aging population, increasing prevalence of chronic disease states, etc. - are also promoting the growth of telemedicine. The public’s reliance on mobile technologies like tablets and cell phones is also having a significant impact on the growth of telemedicine services. The advent of cloud-based software platforms has enhanced these technologies even further.
Although awareness of the availability of telemedicine options remains low, consumers are beginning to catch on and are starting to take advantage of them more frequently. In 2014 there were almost 20 million video consultations in the U.S., and this number may exceed 150 million by the year 2020. Opportunities exist for providers and health systems to engage this growing population of patients by arming themselves with the right technology in anticipation of this growing adoption.
The recent growth of healthcare consumerism is also driving retail giants like CVS and Walgreens into the telemedicine market. By using the aforementioned cloud-based software platforms to connect patients to providers, health systems and retailers alike are supporting the booming growth of a vast array of technology start-ups. The savviest of providers have already figured out that you need to engage patients and personalize their experience throughout the healthcare journey to be successful these days.
As technological advancements continue to impact healthcare, the applications for which telemedicine can be applied will also continue to grow. The post-acute care market, for example, has become increasingly more complex and competitive as health systems attempt to keep patients out of the hospital, but in the network. Telemedicine, in the form of remote monitoring of patients in the post-acute care setting – following surgery, pediatric after hours, behavioral health, minor urgent care, etc. - will therefore continue to flourish. It’s up to the patients and providers at this point, to determine who will make “first contact”.