Pending developments in government policy around access to virtual care and reimbursement for services delivered are opening doors for telehealth viability.
Telemedicine is becoming increasingly popular as the financial benefits for providers who offer it come to light. And new policy changes in Washington and around the country are poised to rattle the reimbursement landscape and open big opportunities for hospitals and health systems to drive more revenue from virtual care.
“The U.S. has seen a perfect storm,” said Tyto Care CEO Dedi Gilad, whose company offers telemedicine tools. “With alignment of employers pushing for telehealth, you can see telehealth companies provide more and more services, and bringing more availability of services. It’s grown very fast and the major area of growth is primary care.”
That growth is expected to continue as employers, hospitals and payers realize both cost-savings and new revenue streams for telehealth services. A September study from Nemours Children's Health System examined the use of telemedicine to treat sports injuries, for instance, and found that each visit saves health systems an average of $24 per patient.
That’s just one example. And a lot has happened since then to start paving the way for telehealth expansion.
Three significant policy developments happened in November alone and, although they are not finalized, they point toward a future that providers should understand because it’s coming:
Apple is not the lone tech giant showing an interest in healthcare: Amazon, too, has kept a close eye on the market.
Analysts report that Apple may be poised to enter the mobile healthcare monitoring device, EHR, and healthcare data storage markets.
A June report stated that Apple was working to put health records on the iPhone, where iPhone users could easily access their medical records, including lab results, medical tests, appointments and other healthcare records in one place.
The more recent efforts appear to go beyond healthcare records, however.
Patent US 9723997 B, obtained by Apple back in August, for example, is an electronic device that computes health data of the user based upon sensor data regarding the received light.
In some implementations, the electronic device may also include one or more electrical contacts that contact one or more body parts of the user.
As described in the patent, “in such implementations, the health data may be further computed based on the electrical measurement obtained using the electrical contacts.
According to the patent description: “'Electrical measurements may be used to measure heart function, compute an electrocardiogram, compute a galvanic skin response that may be indicative of emotional state and/or other physiological condition, and/or compute other health data such as body fat, or blood pressure.”
Apple is not the lone tech giant showing an interest in healthcare. Amazon, too, has kept a close eye on the market.
Back in July, Amazon started a secret lab at its Seattle headquarters to explore business prospects in the healthcare sector, including EHRs and telemedicine. At the time Amazon was reportedly considering developing an EHR platform as well as telemedicine and health apps for existing devices, such as its Echo smart speakers, which connect to a personal assistant, called Alexa. It dubbed the project “1492,” the year Columbus first landed in the Americas.
Later, it appeared that Amazon was looking into ways to break into the pharmaceutical sector.
The U.S. Department of Veterans Affairs and Cerner reportedly agreed to an EHR contract in the range of $10 billion, an unnamed VA source.
The $10 billion figure is significantly less than previously reported estimates. In late October, the Politico Morning eHealth newsletter reported a source familiar with the matter said $18 billion is "consistent with what we're hearing from VA, but until the contract is finalized we aren't 100 percent certain what the cost will be."
VA officials expected to award Cerner a contract for the health system's EHR in November, according to the Politico Morning eHealth newsletter. However, officials cannot sign a contract until Congress agrees to appropriations for the Cerner deal, FCW reports. The unnamed source told FCW VA Secretary David J. Shulkin, MD, met with appropriators in early November to discuss the final details.
The price for the Cerner EHR is lower than expected, in large part because of the VA's plan to coordinate with the U.S. Department of Defense, according to FCW. An unsealed decision by U.S. Court of Federal Claims Judge Lydia Kay Griggsby, filed Oct. 18, noted the VA aims to adopt the DOD's EHR system to achieve a "single common EHR system."
The VA's Cerner contract is expected to be implemented in 48 phases, including site visits, user training and onsite support. The VA Secretary's Determination and Findings, as cited in the unsealed decision, noted "having the VA replicate the DOD's existing EHR system will allow the VA to avoid repeating mistakes and capitalize on the DOD's investments."
The Center for Connected Health Policy released its 50 state scan of telehealth reimbursement laws and Medicaid policies trends report.
Here are five report insights.
1. Forty-eight states and Washington D.C. reimburse for some form of live video in Medicaid fee-for-service models. The two states that do not have written definitive reimbursement policies are Massachusetts and Rhode Island.
2. Twenty-one states reimburse for remote patient monitoring under Medicaid.
3. Six states — Delaware, Colorado, Minnesota, Texas, Washington and Wyoming — recently added policies to explicitly allow the home to be an eligible originating site.
4. Nine state boards issue licenses related to telehealth, while three states dropped their telehealth licenses and adopted the Interstate Medical Licensure Compact last year, of which 27 have adopted.
5. Thirty-seven jurisdictions have laws governing private payer reimbursement.
Click here to view the full report.
5G is coming in 2019: Here's what healthcare providers should know about it: Personalization of Healthcare
Last month, Qualcomm announced that it has created a working 5G chip and completed its first test of 5G connectivity on a mobile device. The news follows similar announcements from Ericsson and Orange, Sprint and T-Mobile, which point to the industry steadily pushing a transition from 4G to 5G.
It’s important to note that 5G isn’t just an extension of 3G and 4G networks. The tech is rather a network that combines 4G, Wi-Fi, wireless access technologies and millimeter wave. It also leverages cloud infrastructure, intelligent edge services and virtualized network core.
What’s interesting is 5G’s use of a computing model that pulls insights from data with billions of devices.
“Four factors distinguish 5G from its predecessors: connected devices, fast and intelligent networks, back-end services and extremely low latency,” according to a report by the Center for Technology Innovation at Brookings’ Founding Director Darrell West. “These qualities enable a fully connected and interactive world with a variety of applications.”
By 2020, the 5G network will support more than 20 billion connected devices, 212 billion connected sensors and enable access to 44 zettabytes of data gathered from a wide range of devices from smartphones to remote monitoring devices, the report found.
“The phrase that most pithily captures the impact of 5G within the healthcare sector is the ‘personalization of healthcare,’” according to the authors of a recent report from the Haas School of Business, U.C. Berkeley.
“The much greater ability to continuously gather patient-specific data and the ability to process, analyze and quickly return processed information and recommended courses of action to the patient will give patients greater ability to manage conditions on their own,” the authors continued.
For example, the report found that 5G will better support continuous monitoring and processing sensory devices, which will support the continuous monitoring of patients. The tech will “substantially increase the effectiveness of preventative care.”
Predictive analytics will also improve under 5G through the growth of continuous monitoring. While 5G’s ability to continuously monitor data will develop new data streams, it will also use distributed computing to power analytics and intelligent care.
Jay & Julia Taylor own and operate Caney Creek Studio. Caney Creek Studio is a video production, digital marketing, and social media management agency.