Commercial healthcare providers follow the government's lead
Computerworld - In a move likely to spur the adoption of telehealth care, the Department of Veterans Affairs (VA) has removed a co-payment requirement that may have discouraged patients from using in-home video telehealth as a viable care option.
The move is far more than a cost-cutting measure: it validates telehealth care for commercial physicians and health insurance payers who may have been sitting on the fence.
"This is a very significant move in correcting the disincentive for telehealth care," said Roy Schoenberg, CEO of American Well, which provides the VA and commercial markets with telehealth technology services. "I think this is one of the exceptional examples of how the government has taken a step ahead of the commercial market."
In its new rule, the VA said it hopes to make the home a "preferred place of care, whenever medically appropriate and possible."
The VA's final rule is effective May 7.
Veterans must often travel great distances in order to obtain care at a VA hospital or medical center. To improve veterans' access to VA healthcare, the agency established outpatient clinics in local communities. In hand with that effort, the VA is also in the process of establishing telehealth services.
Telehealth uses real-time interactive video conferencing, sometimes with supportive peripheral devices such as a camera, to closely examine skin. This allows a specialist located in another facility to assess and treat a veteran by providing care remotely.
Like clinical video telehealth, in-home video telehealth is used to connect a veteran to a VA healthcare professional using real-time videoconferencing, and other equipment as necessary. That can replicate aspects of a face-to-face assessment and care that don't require physical contact.
Telehealth has been catching on in the commercial healthcare industry as well, with physicians using video conferencing, social networks, email and instant messaging to communicate with patients.
One of the barriers to the adoption of telemedicine is the lack of universal reimbursements from private payers, according to a University of Michigan study.
Schoenberg believes the new rules will send a message to the commercial market because the Centers for Medicare & Medicaid Services (CMS) closely coordinates with the VA.
"CMS is typically followed by the large commercial payers, the [Blue Shields], United, Well Point and so on," he said. "This is really the first time that the government is saying telehealth has the potential for revolutionizing care delivery, and we have a financial interest in making sure the adoption goes forward."
The market for telehealth is expected to be around $1 billion by 2016 and $6 billion by 2020, according to InMedica, a division of IMS Research.
The benefits of using telehealth include increased access to specialist consultations, improved access to primary and ambulatory care, and reduced waiting times.
According to Schoenberg, physicians who use telemedicine also tend to have more information at their fingertips because they're also using electronic medical records.
"Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital," Diane Wilkinson, research manager at InMedica, said in a statement. "This has led to a growing trend for healthcare to be managed outside the traditional hospital environment.... As a result, there is a growing trend for patients to be monitored in their home environment using Telehealth technologies once their treatment is complete."
Home-monitoring is also becoming increasingly relevant in the treatment of chronic diseases, such as remote monitoring of blood pressure, which allows sufferers of hypertension to manage their condition better and monitor progress.
Home-use medical devices in Teleheatlh services, such as blood glucose meters, pulse oximeters, weight scales and peak flow meters are being deployed to monitor four main diseases - congestive heart failure, chronic obstructive pulmonary disease, diabetes and hypertension.