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4/17/2014
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Telehealth Gains Momentum In Obamacare Era

The Affordable Care Act's focus on population health and cost-cutting is encouraging providers and insurers to invest in remote healthcare technologies.

Crowdfunding The Next Healthcare Hit
Crowdfunding The Next Healthcare Hit
(Click image for larger view and slideshow.)

Once enmeshed in legal and insurance finger pointing and questions about reimbursement, telehealth is flourishing in the era of Obamacare, cost cutting, and consumer-driven healthcare.

Telehealth will generate $2 billion in the US by 2018, Forbes reported. Worldwide, revenue for telehealth products and services is expected to reach $4.5 billion in four years, compared with $440.6 million in 2013, according to IHS Technology.

Sources of growth include busy individuals who prefer the convenience of a video, phone, or other virtual consultation, as well as healthcare providers that use telehealth to augment traditional care. Today, 42% of hospitals use telehealth, according to Health Affairs. Some employers offer telehealth as a benefit. Insurers increasingly incorporate this coverage to decrease the likelihood customers will unnecessarily (and expensively) visit an emergency room.

Two years ago, Online Care Group operated in only seven states, said Dr. Peter Antall, a pediatrician and medical director for the telehealth provider, in an interview. Today, the physician-owned organization serves patients and prescribes in 38 states and sees patients without prescribing in eight others -- growth he attributes, in part, to Obamacare and its focus on cost-cutting, population health, and patient experience.

[Payers are taking notice of fitness gadgets. Read Could Insurance Cover Your Next Fitness Band?]

"Ten years from now it won't even be called telehealth," says Dr. Antall. "It will no longer make sense for a consumer of a high-deductible plan to go to the ER for pink eye."

Or a sore throat, as sales professional Andrew Kahn discovered before embarking on a ski trip to the French Alps. Instead of taking off more time from work to visit a clinic, Kahn closed his office door. Within 12 minutes, he consulted with a physician via a secure videoconferencing connection and received an e-prescription for an antibiotic for the price of his regular co-payment. "If it was just over the phone I'd have been a bit more skeptical," he said. "But this was high-definition video. If I'd wanted to, I could have read the documents on [the doctor's] wall."

Online Care Group's American Well telehealth service is available on smartphones (like this iPhone), tablets, and desktops. (Source: American Well)
Online Care Group's American Well telehealth service is available on smartphones (like this iPhone), tablets, and desktops.
(Source: American Well)

Insurers, employers, and consumers aren't the only ones embracing telehealth. Some physicians find the model helps them balance home and professional lives or complements their busy practices.

Dr. Nicole Boxer, for example, shut down her busy private general practice when she wanted to start a family. Already accustomed to interacting with

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Alison_Diana
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Alison_Diana,
User Rank: Author
4/23/2014 | 2:28:49 PM
Re: Achieving the Triple Aim
Thanks, Bill (and thanks for being interviewed for the story!). EY's guide gives healthcare organizations a good look at some of the considerations they should keep in mind before entering telehealth - not just technological, but organizational and governmental. Interesting and helpful.
@BillFeraEY
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@BillFeraEY,
User Rank: Apprentice
4/22/2014 | 6:12:07 PM
Achieving the Triple Aim
Terrific piece Alison. There are indeed some significant hurdles still to overcome before we get to any sort of cohesive national telehealth program.  As you point out, even now a robuts telehealth program provides the ability for providers to make a quantum leap in delivering lower cost, higher quality, accessible and appropriate health care. We actually recently offered a look at necessary components of a sustainable telehealth program to help providers make that leap- http://www.ey.com/US/en/Industries/United-States-sectors/Health-Care/EY-shaping-your-telehealth-strategy
Alison_Diana
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Alison_Diana,
User Rank: Author
4/21/2014 | 9:31:59 AM
Re: Federation of State Medical Boards is scheduled to vote on a new telehealth proposal clarifying that, for purposes of state regulation, care occurs where the patient, not the physician, is located
@daburt00: The rules for telehealth vary from state to state and are not federally mandated, which is where some of the confusion comes in. Insurers have, for the most part, become much more flexible and agreeable to paying for telehealth services; they are often much more cost-effective in several ways, benefiting patient and provider -- and payer. Some states, however, have a lot of strings surrounding telehealth that make it much more challenging for providers to practice. While hospitals and doctors may, perhaps, be able to practice telehealth in those states, it's challenging (if not impossible) for telehealth-only organizations to operate, as discussed in this story and subsequent comments. 

Of course, that may or may not be a good thing, depending on your perspective. We're seeing more organizations offering telehealth services -- some are 100% phone-based, others include a video option (like the one in this story) -- as a standalone business. These compabnies hope clarification allows them to more easily expand into states that currently have cloudiness surrounding their rules.
daburt00
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daburt00,
User Rank: Apprentice
4/18/2014 | 5:08:47 PM
Federation of State Medical Boards is scheduled to vote on a new telehealth proposal clarifying that, for purposes of state regulation, care occurs where the patient, not the physician, is located
In real life, the patient usually travels to the specialist location for a referred consultation.....either within state, or many times out of state. In these cases, where the patient is located IS where the consultant is located. Currently that specialist does not have to be credentialed in the patient's home state to provide a consultation for the patient sitting in their office.  Why should this be any different for specialist consultations via telehealth?  The consultant is in their office and the patient virtually shows up for an appointment, except the patient does not have to travel to that consultant's office.
Alison_Diana
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Alison_Diana,
User Rank: Author
4/17/2014 | 3:38:24 PM
Telehealth: It's come a long way
I remember first writing about telehealth about 20 years ago or so. Of course, the technologies were much more limited and expensive, but two of the biggest hurdles were legislative and insurance. It appears insurers are eager to adopt and pay for telehealth for obvious reasons. However, several states still lag behind; although they may allow telehealth on paper, the actual rules detailing how healthcare providers must fulfill these programs make it virtually impossible to comply. Let's hope these states catch up soon, especially as most of them involve states with rural areas that could probably benefit most from a sophisticated network of telehealth providers. 
David F. Carr
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David F. Carr,
User Rank: Author
4/17/2014 | 1:44:22 PM
Using telehealth to lower costs?
Is your organization using remote consultations with telehealth technologies? Have they been effective at lowering costs -- ideally without compromising quality?
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