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Barriers to Physician Telehealth Services Need to Come Down

While physician telehealth services offer significant benefits for patient care, there are various regulatory barriers standing in the way.

By Vera Gruessner

- Physician telehealth services have a strong potential to improve the healthcare industry on a large scale, as this technology boosts access to care among patients living in rural locations, enables primary care doctors to reach specialists quickly, and generates greater convenience and engagement throughout the patient community.

Telehealth Legislation and Policy

While physician telehealth services offer these significant benefits, there are various barriers standing in the way. These obstacles make it harder for the healthcare industry to truly tap into the potential of telemedicine technology.

In particular, some state regulations make it much harder for medical facilities to offer physician telehealth services due to restrictions on its practice and complex reimbursement policies, according to The Pew Charitable Trusts.

If these challenges can be overcome, the real potential from physician telehealth services can be tapped into, including lower healthcare costs, stronger connections between different medical specialties, the ability to monitor patients from afar, and greater communication between patients and doctors.

“The technology has opened up this huge opportunity, this game changer,” Allison Wils, Director of Health Policy for the ERISA Industry Committee, told the news source. “The problem is that there are still varying levels of comfort with it across the states.”

There are states that mandate patients participating in a telemedicine visit be accompanied by a nurse or other medical professional at their side. This clearly restricts physician telehealth services from being practiced remotely or at home.

Some states like Hawaii, Ohio, and Indiana do not offer Medicaid coverage for telehealth visits if the patients live a smaller distance from their healthcare providers.

Another major obstacle standing in the way of widespread telehealth use is the fact that doctors often have to be licensed in every state they practice medicine regardless of whether it is practiced virtually or in-person.

Due to these ongoing barriers for telehealth adoption across the states, access to care is being restricted for elderly patients, the disabled, and those residing in rural areas. While some states are concerned over the potential inferiority of virtual care, others are seeking to break down these restrictions and embrace physician telehealth services as a method for expanding quality care to isolated locations.

“In some states, the issue comes down to protecting their doctors from outside competition,” Latoya Thomas, director of state health policy at the American Telemedicine Association (ATA), told the source. “Their doctors with brick-and-mortar practices assume that someone who uses telemedicine is trying to take away patients.”

Both telemedicine and remote monitoring goes back to a time where the health of astronauts was being tracked by physicians on the ground while they took off in rocket ships. Ever since, telehealth technology has grown exponentially more advanced, but its widespread use has been stagnating due to some ongoing regulatory challenges.

Another restriction requires doctors to meet and perform a physical exam on their patients before taking part in a virtual care visit. Some physicians, however, prefer to know their patients in-person ahead of using telemedicine.

“I can’t imagine that I can provide the best care to my patients if I never laid eyes on them, if I never physically assessed them,” explained Russell Thomas, a family practice doctor in Eagle Lake, Texas. 

Both the Affordable Care Act of 2010 and the American Recovery and Reinvestment Act of 2009 brought more federal spending toward telemedicine and health IT, which did give it a push in the right direction, as these technologies spread throughout urban and rural areas. Nonetheless, the barriers – such as medical licensing requirements – standing in the way if widespread telehealth use need to come down.

“Our belief is that if you license a health care provider, you expect them to uphold the standard of care — whatever tools they are using,” Latoya Thomas concluded. “It’s a delivery model that may not be familiar to everyone, but where it is available, it should be used fully.”

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