Recently Medscape, an online medical news resource, surveyed 1423 healthcare providers, including 847 physicians, and 1103 patients to assess their attitudes toward telemedicine and other emerging technologies in healthcare. The results show that while both providers and patients believe that technical advances can be used to improve patient health and increase access to care, they each have some reservations.
When it comes to telemedicine, patients and providers have a few overlapping concerns, but generally the roadblocks they see depend on their perspective in the doctor/patient relationship. The top concern for patients was getting the correct diagnosis. They also pointed to the lack of access to telemedicine as a big challenge. For providers, practice issues were top of mind, with malpractice and liability concerns ranking highest. Not surprisingly, reimbursement was also high on the list.
Every roadblock on the list is a legitimate area for concern. Fortunately, they can each be overcome by the right technology and some additional education. Let’s have a look.
Top 4 Concerns for Physicians
Medical & Liability Concerns (60%)
While every provider should be sure that telemedicine is covered by their insurance policies, liability need not be a barrier to adopting a telemedicine program for a couple of reasons. First, telemedicine has been proven to be as effective as in-office encounters. In fact, more than 10,000 studies have been accepted by the National Library of Medicine supporting the clinical effectiveness and safety of telemedicine.
Next, malpractice claims related to telemedicine are rare. According to the risk management firm, WillisTowersWatson, “To date there has been an almost infinitesimally small number of reported malpractice claims involving telemedicine. Even in those cases filed, telemedicine may not be the primary focus of the plaintiff ’s lawyer. Often, it is merely part of a fact pattern.”
Reimbursement Concerns (43%)
Concerns about reimbursement are reasonable, but a combination of changing state laws and payer policies and new technology are making it easier for providers to put the reimbursement issue to rest. Twenty-nine states have laws on the books requiring that video visits be paid on par with in-office ones. Ten additional states are considering similar legislation.
In addition to the progressive movement in terms of legislation, modern telehealth technology solutions are stepping up to address the reimbursement issues as well. The Chiron Health solution includes our Rules Engine that validates the eligibility of a patient every time a remote visit is scheduled. Our Reimbursement Guarantee ensures that providers will get reimbursed for every verified encounter.
Technical Problems (40%)
Providers are also concerned about running into technical issues, such as poor audio and video quality due to low bandwidth connections. This can be addressed by ensuring that the network infrastructure is sufficient to support high definition video and choosing a telehealth solution that is designed to work in low bandwidth environments. Chiron Health, for example, requires just 10 mbps download and 5 mbps upload. You can test your speed at speedtest.net.
Privacy & Security Issues (40%)
Given the importance of HIPAA compliance it’s no wonder that privacy & security issues come up when providers think about telemedicine. Consumer video conferencing applications are not suitable for clinical encounters because they are not built for security. The good news is that there are purpose-built telemedicine applications that have HIPAA compliance backed in. There are also vendors that are happy to enter into business associate agreements with providers who use their solution.
Top 4 Concerns for Patients
Patient concerns mirror those of providers in some cases, and differ in others. Here are the top five roadblocks patients see to implementing telemedicine:
Not Sure Diagnoses via Telemedicine are as Accurate (64%)
Overcoming this roadblock requires some education. As we mentioned above, hundreds of studies support the fact that telemedicine is as effective for diagnosing and treating many conditions as an in-person visit. Patients need reassurance that providers know which conditions can be effectively managed with telehealth and which require in-person evaluation.
My Physicians Don’t Offer Telemedicine (51%)
Patients have a point with this one. Only 17% of the responding physicians in the Medscape survey reported seeing their own patients via telemedicine. This is a bit of a chicken-and-egg problem. Many physicians haven’t considered telemedicine because their patients aren’t asking for it, and patients aren’t asking for it because they don’t think that physicians offer it. However, the recent surge in the number of web-based healthcare companies that only offer telemedicine is starting to have an impact on the landscape as physicians realize that if they don’t offer the convenience and cost savings of telehealth, their patients will seek it elsewhere.
Concerned About Insurance Coverage (40%)
This is the flip side of the reimbursement issue we discussed above. With advanced verification technology in place, providers can confidently assure patients that their validated visits will be covered.
Privacy & Security Issues (33%)
Of course, patients are concerned about keeping their health information confidential as well. Providers with HIPAA compliant software in place can reassure patients that their information is being adequately protected.
New technologies of any type always come along with a few barriers to adoption. When you are dealing with people’s health, the need to be circumspect is even greater. But with the right information, careful thought, and well-designed technology they can be overcome.