With telemedicine, patients won't have the need to frequent doctors and hospitals nearly as much resulting in healthier outcomes.
For many older Americans, a visit to the doctor is only a mouse click or phone call away. The Centers for Medicare and Medicaid Services recently announced it's expanding reimbursement for telemedicine services following a trend becoming more prevalent in theprivate insurance market.
Medicare already allows people outside of metropolitan areas to access medical care from specialists via telemedicine. With the latest ruling, telemedicine can be used for assessment of older Americans in their homes if they have chronic ailments that need to be monitored. Psychological assessments can also be done now as well, says Jon Linkous, chief executive officer of the American Telemedicine Association.
"It's an important first step, and I'm very optimistic in a couple of years that we can knock down a few more of those barriers," Linkous says. "This is going to take off as we speak."
Under telemedicine, people can access doctors on a Web cam or through a video conference on their phones. The private insurance industry is moving to provide patients access to medical care 24/7 without an appointment with Skype-like technology that lets patients visit virtually with medical staff.
In the private insurance market, most of the care is limited to wellness, prevention and non-urgent conditions. Those conditions include allergies, asthma, bladder infections, bronchitis, coughs and colds, diabetes, diarrhea, eye infections, fever and chills, flu-like symptoms, high blood pressure, insect bites, insomnia, nausea, rashes, sinus infections, skin infections, sore throats, shingles and viral illnesses. Patients are able to renew medications and get lab or medication follow-up work.
Medicare has yet to make the same jump as the private insurance industry when it comes to this level of care, but Linkous says it's coming. Telemedicine is becoming more popular because it's less expensive, provides quick and immediate access to medical care and better medical care in terms of seeing specialists.
"Medicare as the largest single payer in the country has reverberating affects throughout healthcare industry," Linkous says. "The last couple of years, the private insurance and state Medicaid programs have been further ahead than Medicare in reimbursing. This latest ruling is one indication of cracks in the wall. Every year they increase."
Telemedicine covers a broad array of services. The American Telemedicine Association estimates in the last year 12 million Americans have had some type of health services provided using telecommunications, and that's expected to double in two years. The vast majority of those were images read by radiologist, cardiologist and include a CAT scan, X-ray or EKG.
Linkous says there are a number of other services that are increasingly being used for people who are older. A telemedicine specialist is looking at some 30 percent of intensive care beds remotely so they can provide better quality care, he says.
In the last year, neurologists using telemedicine, Linkous says, looked at about 100,000 people who suffered a stroke. That's important because within 60 minutes their chance of full recovery from a stroke is greatly improved.
"It has done a lot to transform the critical care of our healthcare system," Linkous says.
That's especially true for chronic conditions where the most need is for older Americans, Linkous says. That means congestive heart failure, advanced diabetes and pulmonary illnesses, he says.
"One of the things that's really important for that is monitoring so you monitor on a daily or regular basis," Linkous says. "A lot of these people with chronic conditions, especially if they have multiple chronic conditions, become what's known in the healthcare field as "frequent fliers." They're the ones who come in and out of the hospital through emergency rooms quite often. That's a huge driver of healthcare costs, but with a lot of these people if we monitor on a regular basis and react to any changes that might be occurring, they can keep themselves out of emergency rooms and out of hospitals, reducing costs and improving their quality of life."
Telemedicine can be an electronic scale or a device that takes your blood pressure and sends that data over the phone line to a place that keeps the information and monitors it and notifies you if you have a problem, Linkous says.
For example, if you have congestive heart failure, one of the most important measures is your weight, Linkous says. If you suddenly started to gain weight, you're retaining water, which means there might be a problem. It could be addressed before you get to the point where you need to call the ambulance.
"It's used for follow-up care in cases of discharge from hospitals, there are incentives for hospitals to follow up with their patients to make sure they remain healthy," Linkous says.
Linkous says telemedicine won't replace going to a doctor. You can't get surgery in the home or treat cancer on a video conference, he says, but its use will become more prevalent.
"Healthcare is behind other areas in society," Linkous says. "I equate it to banking. If you're older like me, you remember you had to go to a teller to cash a check before they went to ATMs. The banking industry did that years ago and healthcare still hasn't done it yet, but we're slowly catching up in healthcare. Telemedicine as a whole is growing rapidly," Linkous says.
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