There have always been three key hurdles that telehealth and telemedicine faced -- and each is eroding quickly.
- Cost with complexity
- Economic support (reimbursement)
The first is cost of technology and ease of use. As we have often shared, expensive (and tricky to use) hardware has never been the best route to a great telemedicine system -- or to healthcare collaboration.
The second factor is economic. A common question for providers considering telemedicine is, “Can I get paid for this.” As we have noted, the New York State Telehealth Law and others in the country have made a step toward addressing this concern. Medicare still is adhering to “face to face” only reimbursement for reasons that are not completely clear. Given the power of Hybrid Store and Forward telemedicine, we sometimes wonder if the reason is related to lobbying by the incumbent video conferencing interests.
The third barrier to telemedicine and healthcare collaboration is licensure. Each state licenses professionals for practice only in that state. There is little or no reciprocity. The National Counsel of State Boards of Nursing is working on solving this. It has received a letter of support from the National League of Nursing which represents academic nurse faculty.
Spearheading this change is the National Council of State Boards of Nursing which has been developing the Nurse Licensure Compact. The aim is to enable nurses to provide telehealth nursing services across state borders without needing a separate license for each.
Physicians and other professionals have moved in this direction, but more slowly.
In the short run, telehealth can still be practical and a strong basis for healthcare collaboration -- even before these licensure issues are fully solved -- as long as there is a professional “standing at the bedside or in the exam room” who will bear the responsibility for the care of the patient.
Is this not what healthcare collaboration is about anyway?
If you're interested in trying telemedicine in your organization, we offer a free 2-week trial, which you can access here.