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Telemedicine platforms, like all other innovative technological solutions, require proper training and the purchase of appropriate equipment. The extent of the training and the types of equipment required to depend on the sort of solution that is needed.

For example, a more detailed and widespread inpatient telemedicine program which is designed for use between primary healthcare providers and specialists for consultation will obviously require in-depth training and the purchase of equipment such as a telemedicine cart and several types of mobile health devices.

Detractors of telemedicine maintain that virtual visits lack a necessary personal touch, and do not allow for physical exams which are essential for a complete diagnosis. If there is an increase in providers and patients resorting to online consultations rather than face-to-face in-person visits, what could be the possible ramifications of this?

There is no denying the effectiveness and value of in-person visits between patients and healthcare providers – in some cases, they are essential. Telemedicine needs to be used to enhance and complement these in-person visits; doctors can use it to check-in with patients and ensure that care and treatment are proceeding smoothly.

In addition, telemedicine is also great for the treatment of small, minor conditions such as infections, in which case in-person consultations are not usually required. In such scenarios, telemedicine benefits providers, patients and the entire healthcare system as it is both time-saving and cost-effective.

Reimbursement can often be a tricky subject where telemedicine is concerned, as state policies regarding this new healthcare technology keep changing. Various states now have parity laws in place which make it mandatory for private payers to provide reimbursement for telemedicine consultations, as they would for in-person consultations.

Ultimately, the best way to figure out matters of reimbursement is to call top payers and request information on their policies. You may also find it helpful to view our guide on telemedicine reimbursement, as well as this matrix developed by ATA on state policies in this regard.

Another point to be noted is the fact that doctors and providers who are using telemedicine will include a convenience fee in their charges to patients, and these can range from $35 – $125 for each visit. This fee is charged directly to patients and is in addition to reimbursement through payers. However, despite the fact that patients have to pay this fee out-of-pocket, many providers have discovered that patients are generally willing to do so for the sake of added convenience.

The growth of telemedicine in the past couple of years has been significant; however, there are still several obstacles to widespread acceptance and adoption of this practice.
State laws are the main determinants of reimbursement policies for telemedicine services provided within that state, as well as any restrictions in this regard. If a state has passed a telemedicine parity law, for example, private payers based in that state will be required to reimburse telemedicine consultations just as they would with a traditional in-person consultation.

A large number of states have passed telemedicine parity laws – however, bringing about a change in legislation at the state level is a lengthy and often complicated process, which has major ramifications for the practice of telemedicine in that state.

Obtaining reimbursement for services provided through telemedicine is not as simple a process as the one for healthcare provided via traditional medical practice. The state policies for telemedicine are constantly changing, and this has a direct impact on the rules and regulations regarding reimbursement via state Medicaid programs and private payers.

Currently, Medicaid does offer reimbursement for the real-time provision of care through telemedicine; however, there are restrictions involving which providers meet the criteria for reimbursement, where the patient is located, the medical procedures that qualify for reimbursement, etc.

Its steady rise indicates that telemedicine now provides a larger variety of options and more cost-effective solutions. However, in the initial stages, telemedicine programs do require some investment and expenses, in the shape of purchasing and setting up new equipment, and training staff members on how to use this new technology. This means that some independent practices that operate on a small scale might find that they are unable to accommodate telemedicine in their budgets.

Numerous health care providers are already strained on new budgets for technology and training of staff members for EHR systems, which has been made mandatory by the Meaningful Use program.

Currently, as per the law, healthcare providers are granted medical licenses for a particular state, which means they can practice legally in that state alone. For example, as per medical licensing rules, a doctor based in Colorado cannot legally take on a patient located in New Mexico.

This law presents an obstacle for telemedicine, the aim of which is to overcome geographical boundaries in order to allow providers to offer care to patients regardless of location.

As it is relatively new, the telehealth industry is far from having a set of standard rules and regulations for telemedicine. However, the American Telemedicine Association has compiled some guidelines for a variety of specialties, selected on the basis of a survey.

There are a variety of conditions that are not on the list but can still be treated through telemedicine. However, the following conditions are particularly well-suited to treatment through telemedicine: Allergies and asthma, Chronic bronchitis, Conjunctivitis, Diabetes, Hypertension, Low back pain, Otitis media, Rashes, Upper respiratory infections, UTIs, Mental illness/behavioral health, Prevention and wellness services.

The usage of telemedicine is not suitable for conditions where in-person visits and physical examinations are necessary, owing to extreme symptoms, forceful interventions, or in the case of procedures for which certain protocols need to be followed. In addition, in the case of a medical emergency, patients need to call 911 or visit the ER immediately.

Ultimately, providers need to use professional expertise and judgment in order to determine whether telemedicine is or is not appropriate in a particular case.

There are only a few states where the law requires providers to obtain the informed consent of patients before employing telemedicine in their cases.

However, it is always a good idea to do so, whether or not it is required by law in your state. Prior to the first virtual visit via telemedicine, providers need to give the patient a clear and simple explanation of how telemedicine works (the timings during which they can avail the service, privacy matters, scheduling appointments, etc.), the rules regarding confidentiality, what to do in case of technical failure, regulations for contact in between virtual consultations, prescription policies, and the coordination of healthcare with other providers and professionals.

Healthcare professionals need to set aside a dedicated area for practicing telemedicine. This area should be well-lit, have clear audio, ensure the privacy of the patient, and be in a place where there are no disturbances. It is also recommended that healthcare providers set their cameras on a steady and even stand, and fix the cameras so they are at eye-level.

Having a contingency plan in place in the case of emergencies and referrals is also highly important.

Lastly, it is essential for the providers to communicate with the patient in a culturally sensitive manner, via a language that the patient understands fully. If the patient is unable to comprehend the provider owing to a language barrier, the use of telemedicine is not advised.

With the advancing technology, improvements have been done on health care provision through Telemedicine. The preceding denotes the interchange of medical information via electronic communication. Notably, many insurance companies are encouraging their members to subscribe to the above because it saves time and money. Nevertheless, it is important to note that customers fail to receive the care they want.

At times, patients can contact Teledoc and fail to receive treatment. However, these doctors do not refund the money. The preceding is wrongful on the customer. Equally, it is a breach of the doctors’ professional ethics. Consequently, the client is left disadvantaged, since he or she will meet another cost of visiting a regular doctor.

CEO Jason Gorevic claims that investigation on customer satisfaction is done within 72 hours. However, this is not true. Not everybody is surveyed. Kim Guthrie of Texas called for urinary tract infection treatment but he did not receive treatment and was not refunded. Surprisingly, he was not interviewed, likewise for Mc Murrain.

Telemedicine attendants may ignore the client’s explanations. The above results in failure in fulfillment of customer’s health needs. Evidenced by symptoms, McMurrain knew she had a Sinus infection. According to her history, the infection remains on her chest if unattended. Then, she called a doctor for a prescription. Instead of helping, the doctor gave her a lecture on how people use antibiotics excessively. Subsequently, the infection got into her lungs making her sicker. Basically, physicians do not take time to listen to clients because of the rush to attend to others online. The preceding lowers the quality of service offered since caregiver do not understand the customer’s exact needs.

David Hildebrand mentions that their Telemedicine policy is founded on “performance assurances” for call duration, hold times, and affiliate gratification. However, he exempts the standards of care therein. In regard to experience and whether the physicians have credentials, David Hildebrand says they just believe in them and they are appreciated. Honestly, there is a need for assurance that physicians fit in their positions. Inexpert doctors are likely to give an incorrect diagnosis and consequently wrong medication to the sick resulting in adverse consequences.

Flu season is getting worse as time passes by, especially since 2004 when health officials began maintaining health records on the same. A recent report from the Centre for Disease Control and Prevention indicate that 53 deaths have been claimed by Flu this season. Consequently, a report from CNN showed that Puerto Rico and a total of 48 states are under attack from the Flu. The rate at which the Flu is spreading this season is alarming. Those affected or suspected to have caught the disease, are flocking into accessible health facilities for treatments.

Owing to advancement in technology, faster, efficient, and pocket-friendly alternatives for treatment delivery to patients all over the states are currently available. Among the options is telemedicine, a technology-based e-health care service where a patient seeks and receives the services of a doctor through technological means such as teleconferencing, video chat applications, and phone calls. The arrangement is so efficient that it saves hospitals and health care clinics from a backlog of patients whom could otherwise get doctors aid without physically visiting the hospital’s premises.

Some non-life threatening diseases such as seasonal illnesses do not necessarily require a face- to- face contact with the doctor for treatment delivery. Telemedicine moves in to fill this gap and saves the hospital’s facilities for more dire cases. Dr. Stormee Williams seconds the importance of telemedicine in an interview at NBC DFW. He further says that telemedicine can help eliminate the risks of spreading contagious diseases from sick people to healthy ones crowding hospital premises.

Telemedicine gives people an option that not only saves time, which one waste in a waiting lobby to see a doctor but also the inconveniences of taking time off work and the traveling expenses. Another benefit of telemedicine is that most insurance companies cover the services. All that one needs to do is to sign up for the service, contact a doctor, get an appointment, receive a prescription, visit a drug store to pick the medicine and do a follow up with the doctor to ascertain you are doing just fine.

Telemedicine goes beyond flu season. It helps the isolated people, especially in rural areas access treatments. It also helps those with difficult time visiting doctor’s office, like single mothers who can’t leave a child and travel to see a doctor, receive medical services. Telemedicine has proved to improve treatment delivery and save money and time. Therefore, it is paramount for state authorities to abolish regulatory hurdles to telemedicine.

Residents of North Carolina now have access to a secure, HIPAA-compliant, medical service – all available from the comfort of their homes. This new telemedical service, called RelyMD, connects patients to doctors through a secure videoconferencing line. Patients are diagnosed, prescribed medicine, and are able to have their prescriptions renewed, all without leaving their house. For those who are very ill, or have mobility challenges, this service is a godsend for medical treatment.

This service was launched three years ago by emergency medical doctor Bobby Park. He now sees patients every day. “It is really convenient especially when you have bad weather, you can’t get to the physician’s office cause they’re closed,” said Park. For those suffering from the flu this winter, yet trapped due to icy and treacherous roads, this is a safe way to receive necessary treatment.

Patients can access the service online through their laptop or desktop, along as they have a webcam, or through an app on their smartphones. Just make sure that you are video-conferencing capable, and you’ll be seeing your virtual doctor in no time.

Patients that have used the service report short wait times, and a comprehensive, yet not lengthy, doctor visit. Sick children were able to be examined in their pajamas, and families didn’t have to brave the snow and ice in order to have urgent care needs to be met. RelyMD is like a twenty-first-century house call.

The process is similar to Facetime, and even physical exams can be conducted with the video capabilities. All transmissions are through a secure website and any conversation or video recording is protected under HIPAA privacy regulations. Many times, the physicians able to give patients clear direction to conduct the exam through the video link.

Doctor service is not covered by insurance, but the prescriptions from the physicians should be covered under your existing insurance plan. Anyone in North Carolina with the technical requirements can access RelyMD. Each patient visit costs $50.

Telemedicine has proven to be a highly effective means of improving care quality and access in rural areas. According to a recent study by the University of Iowa, patients were seen six times more quickly at rural hospitals using telemedicine in their emergency department than in hospitals without a telemedicine program. Many rural hospitals and healthcare systems are currently using telehealth programs in their emergency departments to triage patients, reduce wait times, and extend care into rural or remote areas.

Telemedicine has the ability to replace in-person visits to a physician’s office, an approach that expands access to care. It also reduces the amount of time a patient spends in emergency departments(ED). With the help of the ED physicians on site and an added telemedicine physician, patient care is significantly expedited. Often, on-call doctors cannot arrive immediately to see patients, but through sound and video technology they are available at the push of a button to assess patients and initiate care.

Patients are connected to off-site physicians who can begin ordering labs and other tests before a patient is even taken back to a treatment room so that by the time they get into the room, a lot more information is available. This helps to treat people faster and get that next patient into a room while providing an enhanced patient experience to all who visit the ED.

Rural hospitals that use telemedicine in their Emergency Departments have significantly reduced workforce shortages and the burden on patients who might otherwise have to travel long distances for specialty care. It has enabled patients especially those with critical time-sensitive conditions to have remote consults with specialists (who are mostly absent in rural communities).

Though telemedicine has dramatically improved rural health care, the loss of net neutrality could slow telehealth access. The move to repeal the net neutrality rules could have serious ramifications for telehealth services, particularly in rural and underserved communities. Not all health systems will afford to pay for bandwidth access resulting in a weakened ability to provide quality care.

Telemedicine allows healthcare professionals to evaluate, diagnose, and treat patients remotely – and it has been an essential benefit in obesity management. With telemedicine, patients can have direct access to diagnostic tools and assessment with less time and travel, all while having their privacy respected. For the healthcare provider, telemedicine provides improved efficiency, and better patient follows through.

Telemedicine and Weight Loss Management

Healthcare coaching via telemedicine has been noted to be effective at reducing body weight in obese adults. Programs that use telemedicine combine three key elements that have helped support sustainable weight loss: a low-calorie diet, the remote monitoring of physical activity, and on-call support. The most equipped dietitian won’t always be live to help a patient with their nutritional questions or whenever they feel like they have plateaued. Telemedicine has galvanized the relationship between healthcare provider and patient.

The Studies

A study published in the Journal of Telemedicine and Telecare, observed the effects of telemedicine on those going through a weight loss journey. An intervention group lost an average of 7.16% of their weight, while the juxtaposed control group only dropped 1.5%.

A total of 30 participants between the ages of 23 and 64 were enrolled in the study. The results showed that 25 participants completed the study, did not have any metabolic ailment, and weren’t using any sort of medication or supplements that could have inadvertently affected their metabolism. Everyone completed a 12-week telemedicine weight loss program, which included a blood pressure monitor and a body composition scale. These peripherals monitored real-time feedback.

Assessments were delivered remotely via a video conferencing app. Doctors were able to use this form of telemedicine to assess a weight-loss journey of 1 to 2 pounds a week. Patients were assigned a health coaching via the telemedicine, while the control group had none. The intervention group also had access to an online curriculum that addressed weight loss goals, triggers, and goal setting.

The results. The study has found that most people who download these weight loss apps are most interested in monitoring their eating habits, not losing weight. With the help of direct feedback from a healthcare provider, self-monitoring was launched into a production cycle that promotes long-term engagement. Participants that have access to a coach increased overall weight loss, as well as average steps for a week, in comparison to the control group that did not have access to a coach.

Even though there are independent factors like social-economic conditions and limitations with technology, telemedicine has been shown it to be a promising feature in future weight loss management plans.

There has been a predicted low number of cardiologists that is causing the Mayo Clinic to look into telemedicine to try some slightly invasive coronary interventions… one of those happens to include entering stents.

The health system that is based in Minnesota recently made an announcement of multiple phases, multiple year partnerships that will take place with a Corindus Vascular Robotics company that is based in Waltham, Massachusetts. There will be a charitable grant in the amount of $3.3 million that will be funded. This grant will be used to develop a platform for telemedicine that will have a remote doctor that will be able to perform percutaneous coronary interventions or PCIs.

Mackram E. Eleid, MD will lead the stent project, which will be called “telestenting”. He is an Interventional Cardiologist at the Mayo Clinic and works in the Department of Cardiovascular Medicine. He is also an Associate Professor of Medicine at the Mayo Clinic College of Medicine. He will be working with the Corindus CorPath GRX System. The process that will enable a remote doctor to guide a telemedicine robot to be able to conduct the procedure for them.

This is a preclinical project that has the backing of the U.S. Health Resources and Services Administration. They are helping in driving this project, and they have also done a study that shows there will be a large shortage of physicians by 2025… this shortage of physicians will include a loss of 7,000 cardiologists. There will also be a shortage of global specialists that will be able to do PCIs.

“Corindus has made a commitment to develop a cardiovascular model that is high tech and that will be able to improve efficiency, put in the latest technology and it will overall improve the care that patients see” according to comments made in a press release by Mark Toland who is the CEO.

He also feels the platform that was given the U.S. Food and Drug Administration approval in 2016 for robotic-assisted PCI in putting in a cardiac catheterization lab, will, in turn, be able to help with the remote treatment that you will need for endovascular disease and stroke. He also stated that “telestenting is at the core of the strategy that is set forth”.