Imagine a world where patients in rural areas far from a nearby doctor can easily find a health care provider to consult with online from the comfort of their own homes; where doctors living in Pennsylvania can help reduce the backlog of patients waiting to see doctors in Mississippi; and where patients can connect to a doctor over the Internet for routine medical purposes with a few clicks of the mouse—like they do when ordering a book on Amazon. Fortunately, this vision could soon become reality, but only if the federal government and the states work quickly to remove regulatory barriers that limit the deployment and adoption of provider-to-patient telehealth capabilities.
Within the past five years, a combination of advancements in information technology (IT) including electronic health records, low-cost, high-definition video conferencing, remote monitoring devices, mobile devices and networks, and faster and ubiquitous broadband networks, has created an opportunity to leverage telehealth services to improve our national health care system. Health care workers can use telecommunications technology to provide clinical services to patients, to monitor patient health, to consult with other health care providers, and to provide patients access to educational resources. Importantly, the technology has reached the point where, in many situations, health care providers can use IT to offer a comparable quality of clinical health care services remotely as they could in person. For example, the widespread adoption of mobile devices like the iPad and iPhone, as well as the deployment of mobile broadband networks, means that a large number of Americans have access to low-cost, high-quality video conferencing capabilities. While telehealth services will certainly not replace all in-person clinical visits, they have the potential to be an important alternative in many cases, while also saving money and increasing convenience.
However, the regulatory and policy environment has not kept pace with the technology, and several barriers must be overcome before patients and doctors in the United States can fully enjoy the benefits of telehealth. Steps needed include: establishing common standards of care for patients; simplifying inter-state licensing requirements for health care providers; and creating reimbursement policies that support telehealth services. This report describes the new telehealth opportunity, analyzes the benefits from telehealth, examines the barriers to widespread adoption in the United States, and proposes a number of recommendations for government. In particular, policymakers should:
- Adopt a standard definition for telehealth,
- Establish a single, national license for telehealth providers,
- Create technology-neutral insurance payment policies,
- Promote interoperability among state prescription drug monitoring programs, and
- Fund research to continually improve the quality and lower the cost of telehealth programs.