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American Medical Association - telehealth priorities for 2017

Where telemedicine has been, where it’s headed

AMA Wire Staff Writer Troy Parks

Telemedicine can speed diagnoses, increase access to care for remote populations, reduce health care costs and even relieve physician shortages. Experts recently gathered to discuss what the technology has accomplished and what needs to happen to take it to the next level.

Physicians who treat patients using telemedicine in multiple states must have a medical license from each state. Since 2014, 18 states have joined the Interstate Medical Licensure Compact, designed to facilitate a speedier process with fewer administrative burdens for physicians seeking licensure in multiple states.

With the compact on track to launch in early 2017, what can be done to make telemedicine safe and practical for physicians and their patients? The 2017 AMA State Legislative Strategy Conference in Amelia Island, Fla., brought together experts in care delivery, policy and regulation to discuss the best way to move forward.

Overcoming workforce barriers

The University of Mississippi Medical Center (UMMC) began a telehealth pilot program in 2003 to link rural hospital emergency rooms and specialists at the Level 1 trauma center at UMMC. The first two years of the program were a success, said Michael Adcock, administrator of the university’s Center for Telehealth. “Since then, the program has expanded to across the state and across many different types of specialties,” he said.

Mississippi is a very rural state with “a lot of great people,” Adcock said. But it also has a lot of health disparities, illness and poverty. Though there are great primary care physicians and specialists delivering care, the main problem, Adcock said, is “we don’t have enough providers.”

So the Center for Telehealth set out with very specific goals: Deliver care as close to home as possible for patients and provide support for physicians who have a lot of patients, whether it be administrative backstopping or guidance from specialists.

The Center for Telehealth now provides services in more than 30 specialties across more than 200 clinical sites, leaving few counties in the state without access to services via telemedicine.

Encouraging adoption

All stakeholders in medicine need to acknowledge “that telehealth is not a different type of health care, it is just a modality of the same care delivery,” said Kofi Jones, principal and owner of KJ Health Matters. “We need to trust physician discretion as we do in any other environment, and this is just a tool in your toolbox for delivering care.”

Telemedicine is currently moving beyond its 1.0 phase, Jones said, and the need to embrace phase 2.0 has never been greater. Telemedicine can move away from “just the urgent care … to real chronic care management [and] real integration into care delivery.”

The focus should be on “letting telehealth do its true job of helping patients stay healthier,” she said.

“In order to do that, what we really need to encourage is provider adoption," Jones said, "because, when providers widely adopt telehealth is when this technology does its best job. Not just health plans or employers or consumers. It’s when providers say, ‘Yes.’ In order to get there, we need to solve provider payment.”

Kofi Jones