Telehealth business

The Business Challenges of Tele-Health or Telemedicine Organizations

Healthcare provider organizations of all kinds, from large hospitals, to small general and specialist medical practices, are trying to find the right mix of technology, facilities, clinical personnel, and information sharing to meet the future needs of their patients. Tele-health or Tele-medicine, as it is also sometimes called, has been one approach that these organizations have made some use of in the hope that greater use of these technology can be made in the future. However, telemedicine is not without its challenges.

Perhaps first and foremostmuch in healthcare revolves around reimbursement. And until recently, reimbursement structures for tele-health services have been limited at best. But slowly, the Government is changing that. As a result, the following services are now reimbursable for telemedicine offerings:
• Alcohol and/or substance abuse structured assessment and brief intervention;
• Alcohol misuse screening and behavioral counseling for alcohol misuse;
• Depression screening;
• Behavioral counseling to prevent sexually transmitted infections;
• Behavioral therapy for cardiovascular disease; and
• Behavioral counseling for obesity.

Many healthcare provider organizations can therefore now offer these kinds of services viatele-health solutions and morecost-effectively treat patients in doing so.

In general, rural healthcare delivery services will see the greatest benefit from telemedicine but many people in urban areas cannot readily make it to the doctor’s office or to a hospital outpatient’s facility. And because home based medical devices can now easily be installed that can record and track a patient’s vital signs, medication regimen, and even conduct genetic or molecular based testing from the comfort of the home, telemedicine can also be used to manage post hospital stay care by monitoring patient’s progress remotely in a very cost effective way.

So with all this positive news what are the challenges for the future use of telemedicine? Here are several that are significant.

Dealing with Security concerns: Legal and regulatory rules surrounding privacy and security must be fully appreciated before any telemedicine based approach is introduced within a healthcare provider organization. Telemedicine typically brings even more sensitive data into the healthcare space, and that may require providers to undertake careful risk analysis on how they are going to gather and store patient data in secure and safe ways.

Getting patients to use Telemedicine technology in the first place
Although a telemedicine solution would seem to be a logical choice for many healthcare situations, adoption, at least so far, has been slow at the provider end and even slower at the patient end. Even where patients own and regularly use a smart phone, computer or tablet (a pre-requisite to the system to work) many will not engage with their healthcare provider via this channel. This is generally because people rarely voluntarily adopt a technology unless they perceive a tangible benefit to exist for them (and not just the provider or doctor at the other end). Effort has to therefore be invested in providing incentives to each patient and then to get them to talk about it to others close to them. According to several recent research studies, as many as 90% of patients are happy to manage their own health more in the future and want to self-manage their health online. However, many of these (as many as 85-90%) still prefer to see physicians in person, when needed, rather than relying on tele-health solutions. This means the transition will take time.

Selecting the right technology
The success of any efficient delivery of healthcare treatment, especially given the sophistication of current technology is based on the information management infrastructure that is deployed. Unfortunately there are many options to choose from (especially because many companies wants to sell into the very large healthcare industry as a whole). Vendors therefore need to be selected which showa good appreciation of the needs of the specific provider and bring proven solutions to bear that can be used by both the provider and their patients and customers.

Online prescribing:
Although any physician should ideally be able to prescribe drugs or medications to patients treated through via the tele-health channel, many states in the US require that there must be a physical evaluation of the patient before a drug can be prescribed. In addition, even where this is permitted without being face-to-face with a patient, greater care needs to be taken when prescribing drugs and making sure that the process is safe at all times.

Tele-health is now a viable and in some cases reimbursable technology which can be used by many healthcare providers, if they choose to do so. However, considerable up front thinking has to be done to design the right system and to put it in place. RX4 has experienced all of these telemedicine challenges in many different healthcare environments and can provide considerable insight and options where the knowledge is limited or does not exist internally.

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Dr Jon Warner

Dr. Jon Warner
CEO-RX4 Group-Taking Care of the Business of Healthcare

Jon is the CEO of RX4 Group based in Los Angeles, California. He can be reached at

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