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Despite benefits, telemedicine barriers remain high


Despite benefits, telemedicine barriers remain high

Increasingly, it's become obvious that telemedicine has a place in the healthcare system, not only to improve care but also to conserve resources. Consider some of the useful applications we've described just in this publication:

* A cellphone-based solution which monitors blood sugar levels and transmits them to monitoring physicians.

* Cellphone-based disease management services that provide patients with a diary, reminders and reports on their condition.

* eICUs, allowing scarce intensivist physicians to monitor several units or even several hospitals' worth of critically-ill patients from one location.

* Technology allowing one healthcare provider to remotely monitor blood pressure levels for its own employees.

Research continues to mount suggesting that telemedicine applications both are clinically useful and cost-effective, particularly for chronically-ill patients who otherwise consume large amounts of resources.

The problem is, at present healthcare organizations face a huge up-front risk if they invest in telemedicine. For one thing, payers aren't reimbursing for most services delivered this way. Then if you add the time and money involved in integrating telemedical data with existing in- and outpatient data, the problem looks far too daunting to approach for all but the best-funded institutions.

Heck, yes, Newt Gingrich and the Center for Health Transformation are onto something when they say government should help along the process of telemedicine adoption. Let's start by seeing Medicare offer some meaningful payment for such services (not just pilot projects).

Turning loose tons of grant money to organizations that upgrade to create a telemedicine infrastructure, or giving them big tax breaks, would be a fine idea too.

The bottom line is that until something gives, telemedicine will remain one of the most effective technologies not being used in the healthcare system. Let's hope that changes over the next year or two. - Anne

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Even with a growing body of good clinical evidence, reimbursement coverage begins with CMS. CMS has the risk aversion you would expect from a federal agency. Telemedicine in any form breaks their control model and it is challenging for them to view it as anything other than a vehicle for uncontrolled systematic fraud.

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