ITIF Recommends Policies to Facilitate Telehealth Growth

The Information Technology and Innovation Foundation (ITIF) has issued a report describing the new telehealth opportunity, analyzing telehealth’s benefits, examining the barriers to widespread adoption, and proposing a number of recommendations for government.

In its report, titled “Unlocking the Potential of Physician-to-Patient Telehealth Services,” ITIF describes the several types of telehealth services, including:

  • Real-time services, where providers interact with patients via two-way video conferencing, online text-based chats and messaging, and the telephone to provide clinical services as a substitute for in-person encounters.
  • “Store-and-forward” services, where providers analyze clinical data after they have been collected using asynchronous communications tools such as email.
  • Remote monitoring services, where providers use IT to remotely monitor and collect data on the health of patients while in their residence or care facility. For example, patients may use in-home monitoring to track indicators such as their weight, blood pressure, and heart rate.

Scope of the Report

For purposes of its report, however, ITIF refers to telehealth as “health care services provided directly to patients using telecommunications technology, including the Internet and the telephone.” Therefore, the report focuses primarily on physician-to-patient services by which patients receive physician care from home, at work, or any location other than a doctor’s office. The authors note that important telemedicine services such as teleradiology (where a radiology specialist provides a service to another physician), mobile apps, smart pill bottles, and other Internet-connected devices that help consumers manage their care, send them alerts, and provide them educational resources are not a focus of the report.

Telehealth Benefits

According to the report, the benefits from telehealth may include the following: (1) connecting doctors with patients without diminishing the quality of care the patients receive, and in some cases, even improving it; (2) using videoconferencing and remote monitoring to increase efficiency and convenience for both physicians and patients; and (3) decreasing health care costs by improving the quality of care and keeping those with chronic illnesses stable and out of hospitals.

Barriers to Telehealth

The report sees the following as barriers to implementation of telehealth: (1) state medical boards defining the standard of care that physicians must provide to patients; (2) state licensing boards establishing the conditions under which health care providers may practice within their state; (3) the lack of consistent health insurance reimbursement policies for telehealth services; and (4) interoperability, or the ability of physicians to access the electronic health records of their patients and share these records with other health care providers.

Recommendations

ITIF concludes that government regulations and policies have not kept pace with teleheath and that certain barriers must be overcome before patients can fully enjoy the benefits of the new technology. The report recommends the following specific actions by lawmakers: (1) adopting a standard definition for telehealth; (2) establishing a single, national license for telehealth providers; (3) creating technology-neutral insurance payment policies; (4) promoting interoperability among state prescription drug monitoring programs; and (5) funding research to continually improve the quality and lower the cost of telehealth programs.

Specific Legislation to Consider

To address the adoption of a standard definition for telehealth, the report recommends that Congress create a federal standard for telehealth that states could then adopt. According to the report, H.R. 3750, the Telehealth Modernization Act of 2013, would do this by defining telehealth to include health care delivered by real-time video, secure chat, secure email, or telephone. The legislation would also specify conditions under which health care providers licensed in a state would be allowed to provide telehealth services.

The report also recommends circumventing the state licensing requirements by passage of H.R. 3077, the TELE-MED Act, which would allow Medicare providers licensed in one state to provide services to Medicare beneficiaries in another.

ITIF is a think tank whose stated mission is to formulate and promote public policies to advance technological innovation and productivity internationally, in Washington, and in the states.