The growth of telehealth: 20 things to know
Although telehealth has been gaining traction in recent years, there is no set definition. A particular source of confusion is whether the terms telehealth and telemedicine refer to the same service — the American Telemedicine Association, for example, "largely views telemedicine and telehealth to be interchangeable terms."
However, other organizations disagree. The U.S. Health Resources & Services Administration defines telehealth as a "broader scope of remote healthcare services than telemedicine," according to HealthIT.gov, including non-clinical services like provider training, administrative meetings and medical education. Telemedicine, on the other hand, only refers to remote clinical services.
Regardless of definition, many patients aren't familiar with the terminology. Almost half of healthcare consumers, 47.7 percent, said they were not familiar with the term telemedicine, according to an Aloft Group report, even though 51.4 percent reported having received an email or text message from a physician or clinician.
Here's what you need to know about this rapidly developing healthcare trend.
1. The top three most popular telemedicine platforms are telephone (59 percent), email (41 percent) and text messages (29 percent), according to a survey by Rock Health. The digital health venture fund surveyed more than 4,000 healthcare consumers across the United States.
2. Video-based telemedicine adoption is experiencing rapid growth, increasing from 7 percent in 2015 to 22 percent in 2016, according to the Rock Health survey. Video-based telemedicine is also the platform with the highest satisfaction rate (83 percent), although all platforms had satisfaction rates above 75 percent.
3. Telemedicine usage is most common amongst those between 25 and 34 years of age; those above 55 years of age are least likely to use telemedicine, according to the Rock Health survey. That being said, more than half of those 55 years of age or older have accessed remote physician care through a phone call.
4. An Agency for Healthcare Research and Quality-commissioned report conducted by the Pacific Northwest Evidence-based Practice Center found the most consistently reported telehealth benefit is using the technology for remote communication or counseling between physicians and patients with chronic conditions, such as cardiovascular and respiratory diseases.
5. Recent research has supported integrating telemedicine into a variety of medical specialties. A study in the Journal of Clinical Psychiatry found that telemedicine is a "viable alternative modality for providing evidence-based psychotherapy for elderly patients with depression." Another study in Annals of Allergy, Asthma and Immunology found telemedicine appointments may be just as effective as in-person visits with an allergist.
6. The top reasons consumers report considering telemedicine are follow-up care for an acute illness (44 percent), symptom tracking or diagnosis (44 percent) and medication management (44 percent), according to a HealthMine survey of 500 insured consumers.
7. The majority of telemedicine users in the HealthMine survey, 93 percent, said the service resulted in lowered healthcare costs. However, only a third of respondents said their health plan offered telemedicine as an option.
8. Thirty percent of telemedicine visits are paid out-of-pocket, according to the Rock Health survey. This proportion compares to those who have visits covered by insurance (11 percent) or employers (10 percent).
9. A 2015 survey from Anthem and the American Academy of Family Physicians' Robert Graham Center suggested poor reimbursement was stunting the growth of telehealth, with 85 percent of the 1,557 surveyed physicians reporting they would consider using telehealth if they were ensured reimbursement.
10. Lack of reimbursement might change in the near future. The majority of large employers, 59 percent, offered telemedicine in 2016, compared to only 30 percent in 2015, according to a Mercer report on employer-sponsored health plans. Mercer hypothesizes that this trend toward telemedicine is to help cut costs in light of recent high-deductible health plans, since the typical charge for a telemedicine visit is $40, while the typical charge for an office visit is $125.
11. Moving into 2017, nine in 10 employers said they plan to make telehealth services available to employees in states where it is allowed, according to a survey of large employers conducted by the National Business Group on Health.
12. Forty-seven states and Washington, D.C., have some form of reimbursement for telehealth in their Medicaid policies, according to a Center for Connected Health Policy report released in spring 2016. Massachusetts, Rhode Island and Utah were the three states that did not have a written reimbursement policy.
13. All 47 of the states provide some Medicaid reimbursement for live video consultations, according to the report. However, the states have a wide range of variation in terms of how they reimburse, including restrictions by medical specialty, services (ex. office visit, inpatient consultation), provider (ex. physician, nurse) and the patient's originating site.
14. The global telehealth market is projected to reach $9.35 billion by 2021, growing at a compound annual growth rate of 27.5 percent, according to a report published by MarketsandMarkets. In 2016, the market was valued at $2.78 billion.
15. In 2016, North America accounted for the largest share of the global telehealth market, followed by Europe, according to the MarketsandMarkets report. In the United States, a number of factors drove market growth, including rising healthcare costs, a shortage of physicians and a growing geriatric population.
16. Telemedicine was the top regulatory issue of 2016, according to a survey of state medical and osteopathic boards in the United States. The Federation of State Medical Boards, which conducted the survey, found that 75 percent of boards named telemedicine as an important regulatory consideration.
17. In recent years, telemedicine has become a popular answer to growing concerns about health outcomes in underserved communities. However, there are significant challenges to telemedicine's growth; for example, lack of Internet access may inhibit its reach in rural areas, while an overall shortage of healthcare providers may pose a barrier for telemedicine users who require in-person follow-up care.
18. The newly created National Quality Forum Telehealth Multistakeholder Committee, funded by HHS, is tasked with identifying best practices for measuring the quality of telehealth-delivered care and with improving the future use of telehealth measures.
19. A proposed telemedicine bill, set for a final vote in the Michigan senate, would set standards for the telemedicine industry, such as requiring providers to obtain patient consent before providing telehealth services rather than meeting face-to-face. It will also allow state officials to formulate rules governing telemedicine.
20. The American Heart Association is advocating for Medicare to provide coverage for all evidence-based telehealth services for cardiovascular and stroke care, in part because these services can reduce cost and increase accessibility to quality patient care. The association’s other recommendations include incorporating telehealth into EHR systems and investing in future telehealth research.
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