The healthcare industry is generally trending towards the requirement for patients to establish a strong relationship with a primary care provider (PCP) who can help to direct and coordinate their care. PCPs keep costs low by managing chronic diseases, only referring a patient to specialists when necessary, and providing preventative care that heads off serious crises before they develop. But many of the services that a PCP performs can also take place via smartphone or video chat. Skin rashes, sinus infections, and sore throats don’t always require a drive to the doctor’s office, but not all states agree that any random physician at the other end of a webcam should be able to make those decisions for every patient.
In Georgia, the PCP-patient relationship trumps speed and convenience. The state requires an initial in-person visit for anything that necessitates a hands-on examination as well as an annual face-to-face to keep tabs on the patient’s health. Tennessee is mulling over a similar requirement, but it may adversely affect low-income and rural patients who can’t always maintain contact with the traditional healthcare system.
But Colorado is taking steps to join California in smoothing the way towards greater telehealth adoption that will allow patients to receive care without the need to get in the car or take the bus. According to the Denver Post, the state’s House Health, Insurance, and Environment Committee unanimously voted to allow the House a chance to prevent health insurance companies from requiring in-person care when telehealth will do just as well. It would also establish parity for telehealth reimbursements, a movement gaining momentum through legislation in states like Alaska, New York, Montana, and Ohio.
“The shift to telemedicine is inevitable,” said Mario Gutierrez, the Executive Director of the Center for Connected Health Policy, in an interview with RevCycleIntelligence. “This is not a fringe technology. It is very much in the mainstream. “Change is coming state to state with leadership. In states where there is real leadership that understands telehealth and sees the benefit of the technology and can make the case for embracing the technology, you see great change.”
But change is slow in other areas of the country, reports the Courthouse News Service. In Texas, the state’s medical board is wrangling with commercial telehealth provider Teladoc over the interpretation of a face-to-face statute that requires the establishment of “a proper professional relationship” before prescribing dangerous or controlled drugs. While Teladoc asserts that the language of the rule does not expressly require an in-person visit as the basis for the relationship, the Texas Medical Board disagrees. The Board passed an emergency rule prohibiting Teladoc from continuing its operations, prompting Teladoc to ask the courts to declare the Medical Board’s sanctions invalid.
As the legal feud simmers in Texas, other states will need to decide if the expansion of telehealth into a truly equal alternative to traditional healthcare is a positive development for providers or not. Telehealth consults are typically significantly cheaper than office visits, can prevent overuse of emergency rooms, and may encourage hesitant patients to seek care instead of ignoring symptoms of an illness. With a national shortage of physicians complicated by dissatisfaction with cumbersome health IT that saps hours from a doctor’s working day, telehealth could be a solution for the fragile and overwhelmed healthcare infrastructure.
Requiring an in-person visit to start off a telehealth relationship seems contrary to the purpose of remote consults, but evidence does suggest that patients who are engaged with a primary care provider are generally healthier, happier, and cheaper. As telehealth becomes an increasingly popular way to receive care, individual states will need to take on the problem of balancing accessibility and expedience with the human touch.
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Autor(en)/Author(s): Jennifer Bresnick
Quelle/Source: EHRIntelligence, 23.01.2015
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