The telehealth transformation

Telehealth is changing the rules of health care and transforming the delivery of care. Nurse practitioners near St. Louis can provide remote support for hospitals in North Carolina, and Doctors Without Borders' clinicians in South Sudan can rely on instant help from around the world.

As telehealth gains ground as a transformative force in health care, providers are grappling with policies that must catch up with the speed of technology.

Studies on telehealth outcomes are encouraging. A 2013 telehealth initiative by the University of Arkansas for Medical Sciences led to a nearly 50 percent decline in readmission rates among chronic heart failure patients after three months. Another study found telehealth could provide positive outcomes in patients with heart failure, diabetes, and high blood pressure.

Consumers are recognizing this opportunity; Reuters reported in December 2015 that up to 15 million people used telehealth services last year, and Kaiser Health News recently profiled the growing popularity for telehealth kiosks by employers including JetBlue and the city government of Kansas City, MO., both to reduce healthcare costs and keep employees healthier.

As the telehealth sector evolves and expands, it offers tremendous opportunities to the health care profession, particularly in its ability to reach, engage, and improve the health of patients who might otherwise not have access to care. Rural patients or those with limited mobility are good examples of such individuals, and the Alaska Native Tribal Health Consortium recently detailed how telehealth enables specialists to treat patients in remote parts of Alaska. The best way to nurture these emerging technologies and their ability to transform healthcare delivery is through broad and inclusive definitions of telehealth. It is neither a separate specialty nor any one profession's exclusive practice.

Combined with studies indicating good patient outcomes from telehealth treatment of chronic conditions, the growing popularity of the sector suggests nurse practitioners (NPs) and other providers will only enhance their ability to improve patient outcomes through telehealth. Beyond video chats and other similar technologies, NPs are connecting with their patients via remote monitoring devices in order to track and improve diabetes management, with good risk reduction and control success. Private companies like PediaQ and PointNurse are developing services to connect patients with NPs to collaborate on a variety of types of care and others like MAP Health Management are leveraging health IT and telehealth to extend the continuum of care, reduce costs and improve outcomes for behavioral health patients.

The growth of telehealth - particularly across state lines - has led to myriad questions over its costs and who is responsible for them, leading to the existing mishmash of coverage. Interstate practice only adds to the confusion; according to a May 2015 report from the American Telemedicine Association, "every state imposes a policy that makes practicing medicine across state lines difficult, regardless of whether or not telemedicine is used."

These issues reinforce the importance of engaging health care practitioners with payers and hospitals to determine how best to serve patients, improve healthcare outcomes and reduce wait times and expense utilizing telehealth. Patient-centered health care demands that all stakeholders focus first and foremost on integrating technology to improve patient health, applying the same high standards of care governing face-to-face encounters as care delivered using technology. Broad and inclusive definitions of telehealth are the best way to ensure those standards are met and that health providers are empowered to employ technology to transform healthcare delivery.

Nursing and physicians' groups are currently advocating for multi-state licenses specifically designed to address telehealth, and more than 200 bills on the issue were introduced in state legislatures last year. State licensure laws bolstering telehealth and its providers should be applauded and actively supported, as should state laws requiring that insurers provide telehealth coverage.

The American Association of Nurse Practitioners is among an increasing number of groups championing legislation and regulations that leverage technology and telehealth to strengthen patient access to health care, while upholding the quality of care patients receive. As state legislative sessions come to a close, it is clear that policymakers, too, are embracing the potential of telehealth to meet the health care needs of the nation and increasingly, recognizing the clinical value of telehealth encounters provided by all health practitioners.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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