August 5, 2014

Congratulations to the rest of the world — you know, people outside the health IT industry — on discovering telemedicine this week. In fact, kudos to some inside the industry for understanding its potential.

HealthTap, a Silicon Valley startup that had focused on the controversial practice of crowdsourcing answers to specific medical questions from a pool of thousands of physicians, on Wednesday unveiled HealthTap Prime, which, for $99 a month, gives people mobile videoconferencing access to doctors from pretty much anywhere in a matter of minutes. Forbes mobile technology reporter Parmy Olson likened it to on-demand car service Uber and to e-commerce heavyweight Amazon.

At that price point, the market is seems to be rather limited, aimed at the well-heeled few who might pay for concierge service from a primary care physician, and Prime customers don’t even get to choose their doctor. But it’s an intriguing idea that takes full advantage of the proliferation of smartphones and high-speed mobile data networks, one that’s getting some coverage beyond the healthcare and tech press.

Meanwhile, Dignity Health, the San Francisco-based health system formerly known as Catholic Healthcare West, publicly unveiled telemedicine robots at three hospitals in Central California to bring in specialist physicians from remote locations. Putting the story in a context consumers can understand, the Santa Maria (Calif.) Sun likened the technology to Apple’s FaceTime videoconferencing app.

Across the country, in Washington, the House Small Business Subcommittee on Health and Technology today held a hearing on how small physician practices are able to expand their businesses and save money via telemedicine. HealthTap got a brief mention, and witnesses reportedly brought up an important, longstanding roadblock to wider telemedicine adoption: lack of insurance reimbursement for telehealth services.

The reimbursement issue is getting attention in the Senate, too. Mississippi’s two senators, Thad Cochran and Roger Wicker, both Republicans, just introduced the proposed Telehealth Enhancement Act, which would open up Medicare reimbursement to more telehealth services, including remote patient monitoring, all with the goals of reducing hospital readmissions, management of chronic diseases and coordination of care. (Interestingly, these are all things that the Patient Protection and Affordable Care Act encourages, but good luck getting any GOP member of Congress to admit it.)

A similar bill failed last year, and Congress is about to take the entire month of August off, then gear up for midterm elections in November that promise to be ugly, so don’t expect any substantive action on this legislation until the lame-duck period at the end of the year. At least this one appears to have bipartisan support.

A bill with a much better chance of passing because it’s already in a joint House-Senate conference, the Veterans Access, Choice and Accountability Act, a bipartisan compromise to reform the embattled Veterans Health Administration, calls for the VA to deploy mobile medical clinics with telemedicine technology to underserved communities. This would expand the VA’s already widespread telehealth network that has helped with everything from trauma care to mental health counseling. (UPDATE, Aug. 1: The bill passed last night and is awaiting the president’s signature.)

Want to know how important tele-mental health services can be to small towns, check out Monday’s story in the Jacksonville, N.C., Daily News. “We provide services all over. It’s not just the community of Onslow County, it’s all over North Carolina,” Christy Harness, director of telemedicine services at Coastal Carolina Neuropsychiatric Center, told the newspaper.

Harness described telemedicine as “kind of like Skype, but it’s a lot more high tech.”

That’s a concept that just about anyone should be able to understand.


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