With the enactment of the 2009 American Recovery and Reinvestment Act, also known as the “stimulus bill”, many initiatives have been launched that will affect healthcare delivery in the future. One such initiative is spending hundreds of millions of dollars to expand broadband for the widespread use of telecommunication in hospitals and clinics. Additionally monetary incentives will be distributed to medical practitioners to convert from paper based tracking of their patient interviews and records to a completely electronic form. The big question is: will these programs to expand the utilization of telemedicine be enough to convince hospitals, doctors groups, and individual physicians to adopt a radical change in the way they have delivered healthcare, a system that has never undergone such transformation in so short a period of time?
It is my assertion that in order for the movement to gain traction and become a permanent fixture in our healthcare system, we will need conclusive evidence that telemedicine is a cost saver for the system and patient, and results in improved patient care and disease outcomes. Certainly the VA system, which has been an early proponent and adopter of telemedicine, is a perfect clinical environment for such data gathering, some of which is already being done as outlined in this article from the Gerson Lehrman Group. According to a recent report released by the Veterans Health Administration, telemedicine resulted in a “25% reduction in the number of bed days of care and a 19% drop in hospital admissions.” This significant improvement in patient care was seen among the VHA’s 32,000 veteran patients with chronic conditions being monitored and treated through a national program called Care Coordination/Home Tele-Health (CCHIT) .
Certainly objective criteria such as these, that have a direct correlation with cost savings, will be a major factor in the future widespread adoption of telemedicine, including remote patient monitoring and patient-physician consultations. The other highlighted and commonly accepted benefits of receiving coordinated care at home versus a traditional medical setting include saved transportation costs, reduced costly visits to the ER, decreased hospital admissions due to early detection of disease onset, and improved quality of care with patients given access to more specialists.
~Dr. Kevin Friedman