Over the past couple of years, we have seen how technology is making a difference in the healthcare system. Advancements in telehealth and telemedicine have created methods to deliver virtual medical, health, and educational services. We have seen healthcare providers partner with rideshare services to increase access to care, and the adoption of medical wearables in the aging populations. In the midst of COVID-19, with many in-person interactions cancelled, telehealth has been vital in keeping healthcare moving forward. With all the success and hype that surrounds these new medical technologies, you may forget to ask about the challenges in telehealth.
Even though digital therapeutics lower healthcare costs and can be just as or more effective than in-person services, there are still issues in adopting these practices. There are indeed challenges in telehealth adoption. Today I’ll explore some of the challenges in telehealth and predict what the future holds for digital healthcare.
Challenges in Telehealth Adoption
Even though nearly 10 million patients receive telemedicine services annually, there are still hurdles telehealth needs to overcome. Not only are there regulation issues, there are also financial and even technological considerations.
Believing the Hype
Like with most new technologies, there is a period of hype. We’ve all been excited for something, like a new smartphone or movie, only to be disappointed later. We get so excited for the possibility of what could be; we may not take the time to recognize what we actually have. One of the challenges to telehealth will be to recognize the limits of telehealth.
We need to seriously consider the current and future research and studies into telehealth services. Healthcare systems are not ready to change the way they can care for their patients unless it makes sense financially, and there is sufficient evidence of success.
Not every telehealth service will be more effective or cost less than comparable in-person services. Furthermore, not every new technology is going to be applicable in the healthcare system. While we should be excited for what telehealth could bring, it is important to also recognize the potential shortcomings.
Cutting the Red Tape
Licensing is one of the major challenges in telehealth adoption. Now that most telemedicine services operate across several states, licensing is becoming a huge barrier. For those wishing to practice across state lines, they will need to follow the rules of the state they reside in and the state of the patient. This can prove to be an issue as many state medical boards require an in-person consultation before beginning telehealth services.
In nursing, nurses currently have to get a license for every state they wish to practice in. To overcome the multistate licensing barriers, the Nurse Licensure Compact (NLC) allows nurses to get a multistate license and practice in any other state that is also a part of the NLC. Multistate licenses for medical professions can help make telehealth a reality for future patients.
Lack of Uniform Regulations
The adoption of telemedicine has been greatly hindered by the lack of uniform regulations throughout the country and from state to state. The Centers for Medicare and Medicaid Services (CMS) are looking to expand telehealth coverage for Medicare because current requirements limit telemedicine practices.
Twenty-three states and the District of Columbia require reimbursement for telehealth services comparable to in-persons services. Other states have limits on the types of technology, patient locations, covered provider types, and may demand in-person consultations. Most states are limited to live video conferencing for telemedicine services. Few states will pay for remote patient monitoring services.
The three Medicaid reimbursement policy changes could possibly save the federal government over $1.8 billion over the next decade. These changes could lower barriers in telehealth and improve access to care, especially for low-income patients.
Technology in Healthcare
Yes, technology is the foundational piece of telemedicine services, but it is also one of the major challenges in telehealth. Telemedicine is about the services provided to patients. Healthcare has been one of the last industries to adopt technology. This is because healthcare technology is about how to better care for patients, and not about the technology itself.
The first part of this technology challenge is determining how to make sure technology meets healthcare requirements. For any type of medical telecommunication, there must be cyber security measures taken. We’ve heard of the various data leaks from healthcare providers as well as large corporations. Software developers need to work with healthcare providers to ensure telehealth services are secure and HIPPA-compliant.
The second part of the technology challenges in telehealth is the actual implementation of these technologies. When you pair multiple technologies, you create large data flows that may not be maintained easily. For example, continuous monitoring of a patient can create large amounts of data that are necessarily helpful. Where will all of that data be stored? Developers and healthcare providers have to collaborate to find data solutions.
Telehealth in the Time of COVID
Now, it seems we are using telehealth for appointments that really should be in person, such as physical therapy. The forced expansion of telehealth during the COVID-19 pandemic pushed it to its limits. We’re learning more ways to treat patients virtually. We’re also seeing more ways that patient care is suffering because telehealth does not provide the same personal, hands-on care that many patients need in order to feel better. In some ways, especially for older generations, it’s turning healthcare into a cold, business transaction and perhaps moving us too far away from the human, wellness aspect of it.
Further Telehealth Adoption Considerations
Even if all the aforementioned challenges had foolproof solutions, there are still challenges in telehealth adoption. Healthcare providers may resist telemedicine because it will create more competition. These providers may be hesitant to cooperate with new licensing policies because they don’t want to compete with competition from other state’s telemedicine networks.
You must also consider the infrastructure necessary for telemedicine success. Many of these technologies will need a high-speed internet connection. What do we do for those areas that are not equipped with a high-speed internet connection? If telehealth services are as effective as studies are showing, how do we make sure those isolated communities get to reap the telehealth benefits?