By Debra Wood, RN, contributor Dec 04, 2018
Telemedicine use has
grown phenomenally as patients become more accepting of remote evaluation,
diagnosis and treatment.
“The use of telehealth is going to grow,” said Mei Wa Kwong,
JD, executive director of The Center for Connected Health Policy in Sacramento,
California. “There is a shortage
of healthcare professionals, and they are not distributed in all the
places people need their services.”
attorney Jayme Matchinski, at the firm Greensfelder in Chicago, added, “Telemedicine
is gaining traction, because it is easy for patients and physicians.”
Stuart Pologe, COO of Night Nurse, which provides telephonic
triage services in 37 states, suggested that remote care is becoming more
accepted by patients and others, due in part to the shortage of providers in
“Access to care needs to be more universally available,
whether in the city or rural [setting],” Pologe said.
Consultant Thomas Davis, MD, FAAFP, in St. Louis, added that
telemedicine can increase a physician’s productivity.
“I can treat more than twice as many acute patients per hour in a
telemedicine practice as I can in the office,” Davis said.
Pearce, CEO of Zipnosis, a virtual care provider based in Minneapolis, added
that “to make virtual
care a reality and meet patient expectations, we need to focus on personalizing
the patient experience, leveraging innovative technologies to tailor care to
individuals’ unique needs.”
ASK A STAFF CARE RECRUITER about telemedicine jobs and other locum
A recent Harvard
public health study
in a Journal of the American Medical
Association research letter found that among members of one health plan,
annual telemedicine visits increased from 0.02 per 1,000 members in 2005 to
6.57 per 1,000 in 2017. More than 83 percent lived in urban areas.
“It’s not just for
rural areas,” Matchinski agreed. “Telemedicine is used in
large metro areas.”
Thirty-two states, as of 2016, have passed parity laws,
requiring coverage and reimbursement for telemedicine. The Harvard study found
that mental health televisits increased in areas with no psychiatrists and
comprehensive parity mandates. However parity laws did not increase primary
care telemedicine visits.
Kwong added that telepsychiatry
is the most reimbursed specialty by public programs, including Medicaid.
Mordor Intelligence, a research firm, released an analysis
of the global telemedicine market share and forecasted compound annual growth of 18.83 percent from 2018 to
2023. It valued the 2017 telemedicine market at $32,842 million. Drivers
include Medicare reimbursement for telehealth claims.
The Centers for Medicare & Medicaid Services has
expended reimbursement in fiscal year 2019 for Internet communication
technologies, including virtual check-ins and remote evaluation services.
Vidyo, an embedded video technology company in Hackensack,
New Jersey, recently released a study that found more than 75 percent of 300
health care delivery organization respondents reported operating or planning to
launch telehealth services. Two-thirds of the respondents plan to spend 20
percent or more of their technology budget on telemedicine.
Elana Anderson, chief
marketing officer at Vidyo, said in a release that she expects “2018 will be the
year that ‘telemedicine’ becomes standard medicine and mobile or remote access
becomes the new normal.”
much of that to patient satisfaction with telemedicine, its efficiency, return
on investment, and timeliness of care.
addressing specific needs
Kwong reported on the federal and state levels a pubic
health telemedicine trend toward addressing the opioid epidemic because of the
limited number of professionals trained to treat substance abuse disorder. “A
lot of policy has focused on counseling and mental and behavioral health,” she
The Opioid Crisis Act includes directing agencies to create
rules related to prescribing opioids through telemedicine.
Emergency departments in community hospitals often rely on
telestroke with a neurologist at a major medical center, and telemedicine
services have been used to help to help remote victims of natural and man-made
Numerous professionals, including dentists and
anesthesiologists, can practice telehealth.
“Dentists usually have a dental hygienist with the patient,
working the exam camera,” said Kwong, explaining that patients may see the
hygienist for a cleaning and the dentist performs the check up remotely.
States Most in Need of Dentists
While Kwong reported that most of the telemedicine
physicians she works with practice telemedicine part-time, some full-time
telemedicine jobs exist with large telemedicine providers, such as American
Well and Teledoc. Some locum tenens jobs with
firms like Staff Care can include a full-time or part-time telemedicine
Opportunities in telemedicine also exist for nurse
practitioners, physician assistants, allied professionals and registered
nurses, with various models for supervision and oversight.
As some of the barriers to telemedicine come down and
patients increasingly expect remote care, the technology will likely grow in
popularity, supporting more jobs.
“This change is coming,” Kwong said.
While telemedicine trends suggest increased telemedicine
use, physicians need to exercise caution before jumping in, Matchinski
Providers must be licensed in the state where the patient is
located. The Interstate
Medical Licensure Compact for physicians and the Enhanced
Nurse Licensure Compact for advanced practice nurses and RNs are
helpful in securing that licensure in member states.
Additionally Matchinski recommended physicians review the
medical practice act in the states they plan to provide remote care, to
understand the scope of practice, to set up protocols for handling calls, to
record calls and save them in the medical record, and to discuss their
expansion into telemedicine with their professional liability carrier.
“Liability is an issue if there is a missed diagnosis or
communication,” Matchinski said. “Physicians need to be careful with it.”
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