The American health care system has been a victim to some key issues like quality of care, access and cost effectiveness. The emergence of modern day technology and communication mechanisms like the internet, smart phones, cell phones and the computers have truly revolutionized the way people communicate, exchange and seek information. The digital information age created by health care informatics has made medical information accessible to people at a timely and efficient manner.
Advanced data transfer and compression technologies have made telemedicine, which entails the transmission of audio/video and still images of patients a reality.(Perednia DA, 1995) While this health IT initiative has proven advantageous over the traditional paper-and-pencil system, health care IT soothsayers predict that this wave of revolution could positively alter the current model of health care delivery in industrialized nations like the United States and the world over. (Balch & Tichenor, 1997) (Organization, 2010)
Telemedicine bridges the gap between the health care provider and the patient. Telemedicine should not be mistaken for a separate medical specialty; instead it’s a tool that can be used by health care practitioners outside of the traditional medical setting in delivering care to people. The goal of telemedicine and related technologies is to provide medical expertise to patients through improved efficiency and lowered cost of care delivery.
The Organization of Economic Cooperation and Development conducted a survey in the United States and other EU countries to determine the rising costs of health care as a share of GDP (Gross Domestic Product) and concluded that IT played a very important role in reducing health care costs. (C.I.Jones) How do we define Telemedicine? There’s no single acceptable definition for Telemedicine, so this paper presents two of the many working definitions for Telemedicine. The American Telemedicine Association (ATA) defines it as-
“The use of medical information exchanged from one site to another via electronic communications in order to improve patients’ health” (Association) The Institute of Medicine defines Telemedicine (IOM 1996) as- “The use of electronic information and communication technologies for health care delivery when distance separates the participants i.e. providers (physician/specialist, nurse/physician assistant and therapist) and the patient” (4) Telemedicine covers the length and breadth of health care and medical practices. In other words, the number of telemedicine providers is increasing and they are expanding to cover an entire array of health care specialties from cardiology to dentistry to trauma surgery to dermatology to ophthalmology. (Gupta & Sao, 2010)
Barriers to Telemedicine Telemedicine has still not scratched the surface in terms of its full potential. There’s reluctance and fear both from the provider as well as the patient. Policy changes in multiple areas need to be brought that serve as road blocks for practice and implementation.(Krizner, 2002)
1. Lack of Medicare reimbursement for remote telemonitoring. 2. If the site of care is home, then it’s not considered as valid for reimbursement. 3. There’s misalignment of incentives for outcome of care. For instance, medical offices are incentivized via Patient Centered Medical Homes to improve care delivery. (Kathy Duckett RN) 4. There’s a growing fear among providers that telemedicine will increase the volume of work, increase the likelihood of legal liabilities and lead to loss of provider control. 5. Public awareness regarding telemedicine and telehealth remains low as the target audience like the aged population/ baby boomers, handicapped, critically/chronically ill and their care takers are not exposed to whatever information exists about telemonitoring. 6. Lack of infrastructure in remote and rural areas of the country. 7. Lack of interoperability standards amongst providers that enables widespread adoption. 8. One of the prerequisites to Telemedicine usage is the adoption of EHRs/EMRs. A number of providers in the rural areas are not equipped.(NEHI, 2009)