To be candid, the title of this article is not exactly what it is about, but now that I have your attention . . . "Telehealth" means the use of real-time, interactive audio, video telecommunications or electronic technology or store-and-forward to deliver healthcare within the scope of practice of the healthcare provider. To put it simply, telehealth uses things like a computer or smart phone to deliver healthcare. Telehealth will most certainly become ubiquitous. In 2013, the number of patients using telehealth was less than 350,000. In 2018, the number is expected to rise to 7 million.
Telehealth can reduce costs in the healthcare system by cutting travel time, reducing initial hospital visits and readmission rates, and providing better access to care, especially in rural areas. My mother, who lives in a rural area and is almost 80 years old, has embraced telehealth from her computer at home because it keeps her from having to go to the doctor so often for conditions that can be handled with a simple prescription of something such as an anti-biotic. Plus, it is less expensive than an office visit. Whereas an office visit may cost well over $100, a telehealth visit for primary care costs about $40. For those patients who have high deductible health plans, this method significantly reduces costs of primary care. For employers, it is often a solution to keep employees from time off of work. For patients that present to a hospital emergency department with stroke systems, for example, the availability of the ED physician's having prompt access to a neurologist in real-time video saves lives.
Telehealth sounds totally impersonal to many people, including physicians, and it is not the typical face-to-face visits to which most of us are accustomed. But make no mistake—it is the new face of healthcare delivery. In a digital world with a desire for immediate everything, the practice of medicine is finding ways to evolve and stay current with innovation and technology.
The primary legal issues for health care providers wishing to furnish telehealth are: (1) whether to form a separate entity; (2) reviewing reimbursement rates to ensure financial feasibility; (3) determining whether the state in which the services will be provided has coverage and/or payment parity; (4) state licensing issues; (5) ensuring adequate liability insurance coverage; (6) drafting of terms and conditions of use; (7) obtaining meaningful informed consent; (8) assuring compliance with the HIPAA privacy and security rules; and (9) reviewing and negotiating software license agreements and other intellectual property matters.
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