Health and Human Services has a branch called the Health Resources and Services Administration which has an office called the Office of Health Information Technology which has an office called the Office for the Advancement of Telehealth which has supported several regional Telehealth Resource Centers. Whew, enough bureaucracy for you? May explain why telemedicine and telehealth haven’t really gotten the federal support they deserve. In any event, one of the resource centers has issued a white paper on the effects of EHR and HIE support on the advancement of telehealth and telemedicine, particularly in rural areas where telemedicine is a critical method for getting important clinical resources to the patient quickly and inexpensively. (White Paper)
The report contains a good overview of several initiatives which should have a positive and interacting impact on the spread of telehealth. The stimulus bill’s provisions for incentives to adopt and use EHRs, and ultimately to penalize their non-use, facilitates providers’ ability to have immediate access to relevant aspects of a patient’s health records and those EHRs are the natural resting place for health information gathered through remote patient monitoring. The stimulus bill also encourages and funds the growth of health information exchanges, which are predicated on the interoperability required by the EHR provisions and which should allow for the rapid and easy exchange of clinical and administrative data among multiple providers and payers and even patients. In addition, the FCC and other agencies are funding and otherwise assisting in the growth of broadband connectivity, both in rural areas and in underserved urban areas. This level of connectivity is critical for the exchange of many forms of complex health data, particularly imaged scans and video clinical encounters.
The report only in passing notes the many barriers which in the past, and still today, limited growth of telemedicine. Those barriers included not only infrastructure issues such as adequate connectivity, standards for interoperability and lack of electronic health records, but also a mismatch between the bearers of telemedicine costs and the recipients of its benefits; a mismatch which was not alleviated by reimbursement policies. The vision set out in the white paper has value, but will only be achieved when there is a recognition of the benefits to the entire system of encouraging greater use of telemedicine and telehealth and that vision is buttressed by adequate payment for those services.