One of the more fascinating and exciting elements of living in these times is the rapid development and deployment of technology designed to enhance and improve our lives. But the technology often outpaces us and advances rapidly, leaving gaps between what technology can offer and what it actually achieves.
We’ve seen this happen in many industries. Smartphones for example, are becoming an increasingly important tool not just to text your mother, but to manage her healthcare in later years. Even with smartphones, the technology is moving so fast that cutting edge technology from just a few years ago is now obsolete. Take a look at the differences between an iPhone 4 and an iPhone 6.
Expanding access to care through the technology available today in a safe and closely monitored system is important. But while state medical boards and other policy makers and care providers are putting technology to work for patients, the existing technology infrastructure - from a system of medical reimbursement for fee-for-service care, to deficiencies in access to broadband internet, to weaknesses in physician education and training about technology - is holding us back.
The Alliance for Connected Care, a special interest group that advocates for the expansion of telemedicine, contends that data from 2009 shows that of the 43 million Medicare participants receiving care, just 14,000 received that care through telehealth systems. They cite federal geographic and site restrictions on Medicare reimbursements to doctors as the underlying cause for this discrepancy.
Despite these challenges, telemedicine is moving forward and utilization will undoubtedly increase.
Earlier this year, representatives of the nation’s state medical licensing boards unanimously adopted a Model Policy on the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, providing much-needed guidance and a basic roadmap for state medical boards to use in overseeing the use of telemedicine technologies in the practice of medicine. The policy also serves to educate licensees as to the appropriate standards of care in the delivery of medical services using telemedicine technologies.
Among its key provisions, the model policy calls for maintaining the same standards of care that have historically protected patients during in-person medical encounters for medical care delivered electronically. Care providers using telemedicine must establish a credible “patient-physician relationship,” the policy says, ensuring that patients are properly evaluated and treated and that providers adhere to well-established principles guiding privacy and security of personal health information, informed consent, safe prescribing and other key areas of medical practice.
The guidelines are designed to provide flexibility in the use of various types of technology by physicians – ranging from telephone and email interactions to videoconferencing – while maintaining widely recognized standards of patient care. The guidelines are advisory, meaning that state medical boards are free to adopt them as is, modify them, or retain their own current policies regarding telemedicine. They reflect a good faith effort by state medical boards to offer constructive solutions to some of the challenges facing telemedicine in the years ahead.
At the same time, federal leaders are beginning to take a closer look at how to responsibly and safely enable telemedicine to reach more Americans in need of care but unable to easily access the health care system in their community. While real questions about the quality of care, costs, accessibility, efficiency and other challenges remain, the technology and health care industries are moving ahead in this direction and telemedicine is already becoming part of the fabric of discussions about modern health care.
If telemedicine is to succeed, however, the technology supporting it needs to improve and be more interoperable. Congress should examine policies that modernize the delivery of medical care while protecting the quality of care for patients. Moving quickly, but deliberately, is important. We need compatible and secure technologies that can talk to each other. In the end, we can’t succeed in a smartphone world with a flip-phone infrastructure.
Chaudhry is the president and CEO of the Federation of State Medical Boards.