The Virtual House Call - Telemedicine
Over the past decade, I have done quite a few Health Care related engagements. These engagements ran the gambit from integrating islands of technologies within hospital systems (pharma; labs; EMR; bedside; …) and the challenges that arrived with the new independent surgical centers; retail walk in clinics and other new Accountable Care Organizations (ACO) that are popping up nearly everywhere. The start and stop of the ICD 10 initiative has kept nearly everyone involved in health care dreading the day the new codes will really (finally) take effect. (Believe it or not, there is a code to cover an injury suffered from falling into the SAME manhole more than once!)
No matter any one’s politics regarding the Affordable Care Act (“Obamacare”), I don’t think there is anywhere that it would be argued that the expense relative to delivering health care; the efficiency in which it is delivered; the efficacy of the care provided and the expediency are the primary focal points that need attention the most.
While speech recognition technology was demonstrated in the early 1960’s, it wasn’t until processing power on the desktop and inside the mobile devices reached a certain point (the late 1990’s) that we saw it as more than a parlor trick. Today, technologies have matured enough to usher in a new wealth of capabilities in health care that were, before now, simply “great ideas.”
One thing that has been around since the country doctor’s house call but hasn’t really taken off…until now…is telemedicine. In a raw form, a call went to the town doctor and symptoms were described over the phone. Minutes later, the drug store delivery boy scooted off on his bicycle to deliver the prescription the doctor called in.
Today, pervasive access to the internet and cellular networks will bring ever increasing health care capabilities to more people in urban and rural areas alike. The emerging term is “Digital Health” and it has offshoots titled “telehealth,” “telemedicine,” “telecare,” and a dozen of other terms that will come into fashion over the next few years.
The percentage of healthcare employers offering telemedicine is expected to increase by 68% this year, from 22% in 2014 to 37% in 2015. Ironically enough, the growing population over 60 years of age are less technology averse and more desirous of an option away from the standard doctors’ waiting room. While doctor’s stack up patients in waiting rooms and exam rooms in a fashion that rivals stacking up arriving jetliners at O’Hare airport, people are turning away from the lengthy waits and moving toward the retail walk in clinics and “dial a doctor” alternatives.
The perceived and realized benefits are quickly showing to be greater than the expected shortcomings. While lower costs and faster access could encourage more frequent contact with health care providers by those who are convinced that they are stricken ill more than most anyone else, the advancements in Electronic Medical Records (EMR) and a path to integrating them for access by all ACOs, even these frequent patients will be better managed.
For example, Carolinas HealthCare System recently rolled out a virtual visit program that allows any of their one million eligible patients to access a provider at any time for a flat fee. One significant challenge is the lack of medical standards that cross state borders. To date, 26 States have passed some sort of parity laws to endorse the adoption of some form(s) of telemedicine.
But not all States are climbing eagerly on the bandwagon. States voting for “parity,” a term used to enable payors to recognize a remote office visit/treatment in the same way as they do a physical one is growing steadily. A primary driver is how telemedicine can provide better quality services to rural populations. In a state like Texas, 200 counties are considered medically underserved, and more than a dozen counties have just one primary care doctor.
The telemedicine market stood at $17.8 billion globally in 2014, and is anticipated to grow at a compound annual growth rate of 18.4 percent through 2020, according to recent research—one of the segment’s most critical issues is that there is so much variance in its regulatory policy. In April, the Texas Medical Board voted to require physicians to conduct in-person visits with patients before providing diagnoses or prescribing drugs by phone or video. The only exception would be if a patient is at a healthcare facility such as a hospital, clinic, or pharmacy, and has another healthcare professional with them. Mental health visits are excluded from the rules.
At least one area of coverage that has been curtailed by several states: the use of telemedicine to prescribe “abortion-inducing drugs” was banned in Arkansas and Idaho in 2015, bringing the total number of states that have done so to 16.
Seeing these as growing pains and earnest efforts to manage this explosive trend, telemedicine is “on its way!” The Federal Government posted in the Federal Register on May 22 the means to access Federal Grants for the development of Telemedicine solutions amounts from $50,000 to $500,000 to discover ways to better serve rural populations. ([Federal Register Volume 80, Number 99 (Friday, May 22, 2015)][Notices][Pages 29602-29609]From the Federal Register Online via the Government Publishing Office [www.gpo.gov][FR Doc No: 2015-12222])
Sooner than we imagine, consider an enhanced FitBit that would collect and send heart rate; blood pressure; temperature and collect and provide blood sugar readings and the wearables space will have an entirely new segment “healthy wearables!”
As I look for my next career move, this one area evokes in me the most passion and potential to leverage all my skills in strategy; corporate finance; marketing; business development; and commercializing new markets and it will be, most likely, where I will find myself. Telemedicine.