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Challenges and Solutions of Adopting Telehealth Technologies

By Vera Gruessner

- Ever since physicians began adopting telehealth technologies and incorporating video consultations in their medical practice, various hospital associations and societies began to appear in support of telemedicine services across rural locations to support patients unable to access high-quality healthcare assistance. The American Telemedicine Association (ATA) is the leading organization that supports the widespread and appropriate use of telehealth technologies to improve value in heath and medical care delivery.

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This fall, between September 16 and 18, the ATA will be holding the 2015 ATA Fall Forum in Washington, D.C. Recently, sat down with Dr. Reed Tuckson, President of the American Telemedicine Association, and Managing Director of Tuckson Health Connections, LLC, to learn more about the challenges of the telemedicine space and how telehealth technologies are innovating the healthcare field.

“One of the major issues that people are discovering as they develop telehealth networks is the challenge of interstate licensure,” Tuckson began. “This remains a major issue as the providers of telehealth services work across state lines to bring these important and valuable services to people who are in need – whether those people be physicians and other health professionals or patients and consumers.”

What achievements were procured at the American Medical Association?

Dr. Tuckson previously served as the Senior Vice President for Professional Standards of the American Medical Association and spent some time discussing his biggest achievements at this organization.

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“One area I particularly enjoyed and I thought was particularly important was our work on physician-led performance assessment. The American Medical Association at that time launched a bold initiative called the American Medical Accreditation Program, which included among its elements evaluating physicians and certifying physicians based upon a commitment to practicing the highest ethical standards and meeting quality of care performance metrics,” Dr. Tuckson continued.

“It was also intended to be a simple and easy way to achieve certification by using a national certification process. But, the most important component was the goal of developing performance measures that would then be useful in evaluating the quality of care and help physicians improve through a learning cycle. Unfortunately, that work was a little ahead of its time and the profession was not prepared to implement the full program, so the work was largely abandoned,” he explained. “We have now seen over the years, others from outside of professional medical societies taking leadership in moving this field forward,” Tuckson stated. “I am proud that under my leadership, the AMA retained some engagement in developing performance measures through the formation of the Physician’s Consortium for Performance Improvement. This Consortium comprised by medical specialty societies continues to develop performance measures that the field can use and other stakeholders in healthcare can take advantage of.”

What are the biggest challenges of developing a telehealth network? 

“One of the biggest challenges in developing telehealth networks is the problem of interstate licensure,” Tuckson positioned. “Because telehealth service delivery often crosses state lines, physicians are now required to become licensed in all of the states from which their patients arise. I think there have been some promising signs that organizations like the Federation of State Medical Boards are looking carefully and responsibly at these issues, and are trying to find ways that will be effective at being more efficient for physicians who seek to use these kinds of practices.  We are encouraged by the momentum that the FSMB’s licensure compact is achieving. It is our hope that this compact will prove to be an efficient and cost-effective way for physicians to achieve licensure while simultaneously addressing the state medical boards essential role in protecting the health of the public.”

“Another major challenge in creating networks is reimbursement. The good news on this is that we are seeing private insurers embracing telehealth and moving rapidly to incorporate these services more fully and seamlessly and reimbursing with parity for traditional in-person services. This is very encouraging.”

READ MORE: ATA Survey: Parents Like Telehealth for Primary Care Needs

“Where the news is not as encouraging is on the Medicare side. Many of us have real concerns for the slowness in Medicare’s adopting reimbursement for telehealth among publicly insured care for America’s seniors. I think that’s a big issue going forward.”

What are some typical concerns healthcare providers have with adopting telehealth technology? How does the American Telemedicine Association address these concerns?

“Physicians realize that, there is fundamental and profound change occurring in almost every aspect of the practice of their profession. Innovation is occurring everywhere in ways that touch so many parts of a physician’s life,” Dr. Tuckson explained. “Whether it is understanding the basic clinical sciences that underlie the practice of medicine or the alignment of reimbursement with demonstrated quality and cost-effectiveness, just to name two, many transformations are confronting today’s health professional.”

“Telehealth services represent a significant component of today’s innovation in healthcare delivery. We are witnessing exciting advancements across the spectrum of telehealth services from direct-to-consumer mHealth services, services that support the relationship between the primary care physicians and specialists, and specialized remote care for cases such as strokes and other emergent conditions. I think what physicians really deserve and require is realistic information based on scientific evidence about what works and what doesn’t work; for whom these services are appropriate and under what conditions; and how to make the right decisions in association with their patients that enables them to use these tools effectively and not be overwhelmed by the volume of information that is coming from these tools.”

“What we are doing at the ATA is to continue to provide physicians with the information they need to keep up with new developments in the field and how to incorporate these developments appropriately into their practice. We think this is so important that are are intensifying out outreach to professional medical societies to advance this goal."

READ MORE: Telemedicine Success Linked to Workflow, Rather Than Technology

“Given that physicians and all stakeholders need evidence to make appropriate decisions, we at the ATA will also be working to enhance our nation’s research enterprises capacity to conduct the necessary scientific studies and analyses. We really think America’s research enterprise needs to have more funding and manpower to answer the kind of questions that accompany the explosion in telehealth services."

“The good news is that there is more than sufficient evidence to develop guidelines on appropriate telehealth clinical practice. I am pleased to report that the ATA has developed fourteen guidelines to date and there are many others in the pipeline."

“Innovation is a wonderful thing and America is categorized by its commitment to and capacity for innovation,” Dr. Tuckson concluded. “However, within the world of innovation, we remind ourselves that innovation is meaningless unless it leads to value. All of us at ATA are obviously excited by the progress our industry has made to date and the meaning of that progress on improving the health status and medical care delivery for the American people and those around the world.”


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