Challenges Implementing Telemedicine
Inadequate telemedicine parity laws and Medicare reimbursement are among the top challenges implementing telehealth programs, according to a survey out of Reach Health. Forty percent of respondents said the parity laws issue is going unaddressed, and 37 percent said it’s only partially addressed. Thirty-nine percent said Medicare reimbursement problems are not addressed, and 40 percent said they’re partially addressed. Other challenges included Initial Costs and Investments, Lack of Face-to-Face Interactions, Patient Technology, and Payment and Insurance Coverage.
The Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services defines telehealth as “the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.” Medicare also defines telehealth as “providing care via interactive audio and video telecommunications systems.”
Telemedicine and Telehealth
Though telemedicine is often used interchangeably with the term telehealth, there are specific restrictions on who can implement, provide, and use these services. The term telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole to allow for the delivery of remote healthcare services.
Telemedicine involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. This (telemedicine) technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation, and a host of other clinical services that can be provided remotely via secure video and audio connections. Additionally, there are specific professional codes (CPT/HCPCS) that can be used to report telemedicine and telehealth services. Apart from the federal requirements, there are many state regulations that pertain to telemedicine and telehealth.
Challenges Implementing Telemedicine
Initial Costs and Investments
The initial cost associated with the development and implementation of telemedicine is a major challenge implementing a telemedicine program. Resources are used for planning, coordinating and consulting with potential vendors, implementing new technologies, complying with all requirements, training, go-live, initial support after go-live, and the time of all telemedicine staff. Electronic systems can be costly to purchase, develop, implement, and maintain. In addition, all appropriate staff should be fully trained on the systems. The willingness to change and adhere to new processes is dependent on the culture of the organization and the employees themselves.
Lack of Face-to-Face Interactions
Patients want to be sure that the care they receive is personal and tailored to them as an individual. These patients want to have an established and trusted relationship with their providers. However, the virtual environment of telemedicine programs can be perceived as impersonal. So lack of face-to-face interactions can be treated as one of the major challenges implementing telemedicine. Providers should ensure that all telemedicine encounters are interactive, personalized, and empowering for the patient. In addition, the telemedicine system application environment should be interactive. The innovation and creativity of the system and personalized patient encounters will lead to higher patient satisfaction and patient engagement scores.
Remote encounters often involve technology or internet connections that are not provided by the telemedicine organization. Patient computers, tablets, or smartphones may be used to connect with providers. Telemedicine encounters at the patient’s home are connected through the patient’s home Wi-Fi network where interface issues at the patient location may occur such as lagging video feed, low-quality video, or internet outages.
In addition, a patient’s home Wi-Fi network or mobile device does not have the same security features as an organization’s system. This could potentially risk patient privacy and security. The telemedicine platform and feed must be secure and encrypted during all patient encounters.
For some patient encounters, the technology itself can be a challenge. Some patients may not be as familiar with the functionality of their mobile devices, internet connection, or telemedicine application. It is important that providers remain patient and offer guidance along the way.
Some telemedicine organizations utilize telemedicine hubs or local clinics for patients to go to for telemedicine services. These hubs or clinics help to avoid technical issues that may arise at the patient’s home.
Payment and Insurance Coverage
Although telemedicine is an emerging trend, many services are not covered by insurance companies creating challenges implementing telemedicine. Every state has different rules and regulations regarding telemedicine services. Patients who would be excellent candidates for telemedicine services may not be covered and would need to pay out-of-pocket.
As mentioned in the “Benefits” section of this toolkit, employers are more willing to include telemedicine services in their benefits plans. Insurance companies are starting to agree to coverage of these telemedicine services. Although telemedicine coverage is expanding, much work remains to be done before telemedicine becomes part of all insurance providers’ coverage.
Over the past three years, there has been an increase in the number of telehealth programs related to fields like behavioral health and dermatology. Though difficulties persist, healthcare professionals still see telehealth as an initiative worth their time and money. Forty-six percent of respondents said they view telemedicine as a high priority at their organization, and 24 percent see it as one of their top priorities. Seven percent consider it as low on their list of priorities.
E2E Medical Billing Services works with clinicians utilizing telemedicine service lines to improve patient care. Talk to us about the challenges you’re experiencing with an existing service line, or about implementing a new virtual service for your patients. To know more about our telehealth billing and coding services, call us at 888-552-1290 or write to us at info@e2eMedicalBilling.com