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Expert Says Telemedicine Could Benefit More Patients

If you haven’t already experienced telemedicine, you may soon have the option. Technology is helping people connect with their physicians in new ways and from a distance, and interest is growing in updating state and federal policies to help make telemedicine available to more patients.

Mayo Clinic responded to a request from the House Energy and Commerce Committee for recommendations on how lawmakers can help this new healthcare option progress. Steve Ommen, MD, medical director of Mayo Clinic Connected Care, explains telemedicine and outlines state and national moves that would help more patients take advantage of it.

What is telemedicine? Telemedicine most commonly refers to communication with or among a patient’s healthcare team via video connection, secure text messaging, or another platform rather than in person. It can be used to schedule appointments, answer questions, handle routine checkups, allow physicians in different locations to consult about a patient’s case, collect vital signs, or even to help examine and diagnose patients. To protect patient privacy, secure communication methods are used.

Mayo Clinic views development of telemedicine as an important next step to improve healthcare access, quality, and efficiency across the country.

“I think of telemedicine as using technology to meet the needs of patients where they are rather than making them come to where we are,” said Ommen, a Mayo Clinic cardiologist. “There are a lot of things we do in medicine that do not require face-to-face interactions, and we can use technology to meet those needs: prescription refills, or simply exchanging information about how it’s gone since your last visit, for example. A lot of that information can be exchanged electronically in a way that makes it much more convenient for the patient and for the doctor.”

Telemedicine initially developed as a way to provide complex specialty care to rural patients whose local hospitals didn’t have specialists available. For example, Mayo Clinic uses telestroke robots to help swiftly diagnose stroke patients whose hospitals do not have neurologists on hand around the clock as Mayo does. A robot at the patient’s hospital allows Mayo neurologists to perform live, real-time audiovisual consultations with the patient and emergency medicine physicians at his or her hospital; speedy delivery of clot-busting drugs is crucial to halt and reverse stroke damage.

Now, telemedicine can help patients and healthcare organizations wherever they are: Other telemedicine options offered by Mayo include robots on the sidelines at football games to help diagnose concussions; a pilot program offering private workplace kiosks where people can be treated for minor health problems without leaving work; secure messaging, electronic, and video consults; eDelivery rooms that use video and tablets to connect Mayo Clinic Health System delivery rooms to neonatologists at Mayo Clinic; and remote intensive care unit monitoring to support ICU teams at smaller hospitals.

Why are policy changes needed? Telemedicine technology is developing rapidly, but there are policy barriers holding back its use, Ommen said.

“The policies really haven’t kept up, but there is certainly interest at both the state and national level in updating them,” Ommen added.

In the letter to the House Energy and Commerce Committee, Mayo Clinic proposals include:

    ?Lifting geographic restrictions on Medicare reimbursement that only pay for telemedicine services if a patient is located in a rural and/or medically underserved community

    ?Supporting multistate medical licensing compacts, and possibly creating national physician licensing like the U.S. Department of Veterans Affairs physicians have, rather than requiring that physicians be separately licensed in the state where patients live, to make it easier to license physicians who practice in multiple states

    ?Promoting pilot projects on innovative telemedicine delivery platforms and incorporating successful models into the healthcare options available for patients of all ages.

Mayo’s comments to House Energy and Commerce followed a Senate Aging Committee roundtable event last September on telemedicine, including its possibilities and the challenges facing its growth.

“There was almost unanimity in the room that the current legislative barriers were real barriers that needed to change,” said Ommen, who spoke at the Senate event. “My hope is that the discussion will grow, and we could start seeing legislation as early as this Congress.”

Besides convenience, what are some of the other benefits of telemedicine? Mayo research has found that in addition to providing convenient, high-quality care, telemedicine can save money.

For example, Mayo studies on telestroke found that, compared with hospitals without a telestroke network, telestroke systems resulted in the use of appropriate advanced therapies that in turn allowed more patients to return home rather than require nursing home care.

“I see telemedicine as really extending the relationship a person already has with their providers,” Ommen said. “It provides new options for reaching them more urgently and more conveniently. It’s a choice that patients and providers can make to be in better contact with one another.”

This article was adapted from information provided by Mayo Clinic.