New Laws for Expanding Use of Telehealth Tools Insufficient

August 13, 2015 - Younger generations are using mobile devices on a daily basis, including tablets, laptops, and smartphones. Essentially, children and teenagers are often found glued to a screen and find it a more accessible and flexible way to communicate. In medical care, telehealth tools offer a new method for doctors to communicate with their patients by video and audio, which could be beneficial for pediatric care.

As previously reported by mHealthIntelligence.com, The Children's Partnership, the University of California-Davis Children's Hospital, the Center for Connected Health Policy, and the Lucile Packard Foundation for Children's Health compiled a report describing the benefits of using telehealth tools among young patients in the pediatric field. Mario Gutierrez, Executive Director of The Center for Connected Health Policy, spoke with mHealthIntelligence.com and discussed the report further.

mHealthIntelligence.com: “What are some of the most interesting findings you discovered when working on the report?”

Mario Gutierrez: “This is a particularly important report in the context that we were able to bring together a major advocate in the state, The Children’s Partnership, which is very much consumer-oriented advocacy for children, UC Davis School of Medicine, which is one of the leaders in the country in pediatric care particularly in the use of digital and connected care technologies, and the national Center for Connected Health Policy. We use evidence to raise the utilization of telehealth tools and improve the policies across the states and nationally.”

“For me, what really jumped out about this is that it really crystallized a lot of the dilemmas that are occurring across the board in advancing the use of telehealth for improvements in care. Particularly for those who live in rural isolated areas, the value of this technology – once it’s understood by the consumer – is going to be a critical lynchpin in advancing use across the country. Payers are going to be more likely to reimburse and health systems will be more likely to offer it. Hopefully, health policy administrators and legislators will also adapt.”

READ MORE: Ensuring Care Continuity Through an EHR-Integrated Telehealth Platform

“The second thing that really jumped out at me specific to the California experience but would apply anywhere is that changing laws is not sufficient. We went through an intensive process here in California that we helped lead to develop language that would be used for model statutes. Once that report was completed using the advice of some of the best experts in the state, that was then turned over to advocates to persuade the legislators to pass a bill. We now have the most comprehensive bill in the country for telehealth.”

“There was great celebration that we got all these changes. We changed the definition from telemedicine to telehealth. We changed the scope of where telehealth can be practiced from the traditional healthcare facility to just anywhere, which makes it much more patient-centered.”

“We also in that bill allowed for enabling legislation and the state to reimburse for other forms of telehealth other than just videoconferencing. This includes remote patient monitoring. However, the Department of Health Services and the Medicaid program in California were very slow in adopting these changes.”

“To this day, they have not expanded their codes to include remote monitoring. This would make such a difference for children such as not having to travel long distances, being able to be monitored at home, and have virtual visits with their providers. This would improve the quality of care and the efficiency of care, as it does reduce costs. The state has not moved to add those codes for whatever reason.”

“One of the most important recommendations in the study is to implement fully the law that was passed several years ago.”

READ MORE: US Senators Support Permanent Telehealth Access Through Legislation

mHealthIntelligence.com: “What advice would you offer to pediatric care providers who are trying to adopt telehealth tools?”

Mario Gutierrez: “The number one piece of advice I would give them is to learn the laws and regulations governing the uses of the various forms of telehealth in their state through their Medicaid program. Every state is different and, in most cases, states are far behind the advancement of the technologies and the benefits of the technologies.”

“Secondly, I would certainly encourage them to educate themselves on the various telehealth tools that are available. Older practitioners often have a narrow view that it’s only live video consult with a specialist. However, there are many aspects of digital connected health that has strengthened healthcare.”

“It doesn’t replace in-person care. It’s not meant to be a substitute but rather a way to enable better care, better quality, and greater efficiency. To that extent, if the value of it is clear, there would be much more interest on the part of practitioners.”

mHealthIntelligence.com: “What are some of the biggest challenges of adopting telehealth tools and how should healthcare providers or vendors solve these issues?”

READ MORE: Enhancing Patient Access, Experience at Virtual Care's Front Door

Mario Gutierrez: “I think the most fundamental thing that we need to understand is that these technologies are, in essence, tools that help enable, enhance, and strengthen healthcare delivery. Rather than thinking of it as something separate, it needs to be thought of as an integral part of healthcare delivery.”

“In order to do that, there needs to be a real transformation within the healthcare delivery system. I use the analogy of the banking industry and the travel industry – how different they are as a result of the availability of technology and Internet access to complete their services. In healthcare, we now have tremendous power to access high-speed broadband in most areas of the country and the ability to have equipment that is more accessible.”

“We no longer have the big, clunky machines like video recorders and monitors. The ability to use mobile technologies has been liberating. I think there’s been some misunderstanding, confusion, and fear about using these new kinds of technologies.”

“For vendors in particular to understand how the product can be better integrated into the healthcare delivery system is important. You can’t lay on these technologies onto a broken system. It has to be reengineered.”

mHealthIntelligence.com: “What are some of the biggest benefits of telehealth for the pediatrics field? Why is telehealth important for this industry?”

Mario Gutierrez: “Children with special needs require highly specialized consultations and diagnostic services. We have a severe shortage across the country of these kinds of specialists. To the extent that virtual care adds another dimension so that somebody who lives in an isolated, rural community can have the best care as anybody who has access to the best urban centers in the country and the best medical centers. It equalizes the playing field for access to care.”

“For kids, technology is part of their lives. I’ve seen parents with kids who are two or three-years-old with an iPad. It’s part of their life. To be able to have a consultation with a provider using an iPad is not something that would seem out of the ordinary for kids.”

“For psychiatric care in particular, children are much more comfortable using these technologies in the comfort of their home and not having to be intimidated by having to be brought into an institution. One of the stories in our report highlighted that. We need to get the policymakers to come to understand that there’s real benefit here.”