Telemedicine expands care into rural communities
Telemedicine creates possibilities for lowered health care cost, increased provider access and even relief of physician shortages. The past gains and future goals of telemedicine was a topic of discussion at the recently held 2017 AMA State Legislative Strategy Conference in Amelia Island, Florida.
One triumph of telemedicine was noted in Mississippi. The University of Mississippi Medical Center (UMMC) instituted a pilot telehealth program beginning in 2003 that has shown promising results. The goal of the program was to connect rural emergency rooms and specialists with the Level 1 trauma center at UMMC. Two years into the program, the effort was a success according to the AMA Wire, which reported the university’s Center for Telehealth administrator Michael Adcock’s comments.
“Since then, the program has expanded to across the state and across many different types of specialties,” Adcock said.
One of the major hurdles to health care in Mississippi is provider availability. The rural state simply doesn’t have enough providers to adequately serve its population. In addition there are challenges created by health disparities, poverty and illness.
The Center for Telehealth set out to deliver care to patients as close to home as possible while providing support for physicians who treat a high number of patients compared to their peers in other states. The support included administrative backstopping as well as guidance from specialists.
Now well established, the Center for Telehealth provides services to more than 200 clinical sites with over 30 specialties. Virtually all of the counties within the state have access to services via telemedicine.
“We need to trust physician discretion as we do in any other environment, and this is just a tool in your toolbox for delivering care,” Kofi Jones, of KJ Health Matters, told attendees. Jones explained that telemedicine is moving beyond its initial stages, away from “just the urgent care…to real chronic care management [and] real integration into care delivery.”
Physicians expect the same thing from telemedicine as they have in the past from new tools in the medical field. The tools, including telemedicine, need to be safe for their patients, not add to already heavy administrative burdens, and be proved to support patient-centered care coordination. In a recently conducted survey by MCMA Stat, almost 17 percent of respondents already offer telemedicine services. An additional 21 percent have plans to implement the rapidly improving technology. An American Well Telehealth Index survey found that more than half of physicians are interested in seeing patients over video when it’s clinically appropriate.
The key to success may lie in the ability to establish partnerships between providers. Those partnerships are one of the reasons the UMMC project has been able to expand so rapidly. There are still hurdles to face, especially when it comes to health plans.
Allison Wils, who serves as executive director of state programs and senior directory of health policy at ERISA Industry Committee called for the industry to lock arms and “prove what we know.” The time is ripe for state medical associations to have a significant impact on the regulatory environment that best supports the continued development and expansion of telemedicine.
The American Medical Association has a telemedicine campaign of its own that includes model legislation as well as resources for those who advocate for telemedicine. Additionally, the STEPS Forward collection of strategies designed to improve practice will help physicians use telemedicine in real world clinical situations. The materials focus physicians and teach the steps involved in adopting telemedicine and both the challenges and benefits of monitoring patients remotely.
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