The health industry is pushing to make care more accessible by expanding telemedicine. This means providing professional health services through remote communication via technology.
Telemedicine occurs between a patient and a health professional in two separate locations. It may or may not include an intervening insurance provider.
The push for this service is gaining bipartisan support through new legislation. Expanding these types of services is becoming so common to help reduce current healthcare problems nationwide.
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The Need for Access in Rural Areas
Residents of rural areas have more difficulty receiving necessary health services. Not mention the hospitals in those areas are closing their doors.
These patients have…
To travel longer distances
Fewer public transportation options than those in urban areas
Higher average premiums for health insurance
Limited availability due to shortages in healthcare professionals
That last bullet is important. 59.09% of Primary Care Health Professional Shortage Areas were in rural areas.
The map below shows primary care shortages in non-metropolitan areas. The dark green indicates a greater shortage.
National graph displaying areas with shortages of healthcare professionals via RHIhub.
South Dakota and Nebraska, two rural states, proposed legislation to expand telemedical services.
First, South Dakota has two new proposed legislation including parameters for telemedicine. The first lists methods that health professionals can use to deliver services.
Interactive audio-video
Interactive audio with store-and-forward
Store-and-forward technology
Remote patient monitoring
The second includes criteria for a mental health examination of detained patients. The checkup may either be in-person or through real-time interactive audio and video.
Second, Nebraska legislation could provide emergency services to rural nursing homes. These facilities often have few options for treating those who need emergency care. With the new bill, nursing homes would cross-train their health professionals into paramedics.
These workers would link up with a hospital remotely so that residents can stay at the nursing home. This would prevent costly emergency services such as emergency rooms and ambulance transfers.
These services are beneficial to those in locations with barriers to care. If a nursing home patient can’t get to the provider they need, they could access one with ease via new online options.
One new helpful service in a rural area comes from Meridian Health Services.
To help solve an understaffed industry, Meridian set up a “hive” in Indianapolis where there are more doctors. Patients in rural areas visit a local Meridian office where a nurse takes their vitals. The patient then uses a split-screen computer with a physician on the other end.
So far, patients seem to embrace the telepsychiatry. Patients actually feel more comfortable talking since there’s no pressure of being face-to-face.
Crumbling Mental Health Infrastructures
Accessing mental health services isn’t only difficult due to location. There’s a shrinking number of psychologists and psychiatrists. Although there are therapy chatbots that exist to help patients, they’re not quite the same as a licensed professional.
What’s more problematic is that the number of those who need mental health care is increasing. One in five American adults suffer from a mental health illness, but less than half receive care.
When it comes to diagnosis, Medicaid is the main provider for mental health services. But only a quarter of these patients receive the care they need. Part of this is due to the current opioid epidemic.
But the government is making strides to help these people. New bills include telecommunication strategies to tackle mental health issues. This includes telemedicine for substance use disorders (SUDs).
The SUPPORT for Patients and Communities Act expanded where Medicare would reimburse remote medical services. Eligible patients diagnosed with a SUD can receive treatment despite geographic restrictions.
The Mental Health Telemedicine Expansion Act will exclude certain services from Medicare requirements. This enables access to some mental health resources despite restrictions.
Other new legislation also expanded remote prescriptions, as long as physicians follow the standard of care.
Financial Restrictions on Telemedicine
Restrictions on telemedicine services don’t stop at mental health. Medicare and Medicaid also restrict reimbursement in some cases. Some states are proactively trying to tackle this issue.
A new California bill will change its Medicaid program. It won’t require face-to-face contact for any telecommunication services.
The CONNECT Act will allow the Secretary of Health and Human Services to waive Medicare restrictions on telemedicine. These limitations relate to:
Originating site
Geographic location
Technology type
Provider type
Service type
Patients Want Easy Access
Some people choose not to visit a healthcare professional because it affects their schedules. Doctor visits take time away from work, school, and other important daily activities. Long waiting room times don’t help, either.
Telemedicine especially appeals to younger generations who value immediacy in their busy schedules. Plus, they already rely on technology for many daily activities.
One-third of millennials don’t have family doctors. This is due to lack of access, and because society is more fast-paced than it used to be. Healthcare has struggled to keep up, until now.
Millennials also move often for either school or work, so they won’t stay with a family doctor for long. Patients may be more likely to schedule appointments if they can visit a doctor from anywhere at any time. This is possible with increasing telecommunication.
Visiting doctors is also inconvenient for parents with sick children. Picking them up from school, taking them to the doctor, and staying home with them during recovery cuts into valuable work time. Some jobs don’t even allow this flexibility.
Some parents won’t take their kids to the doctor since it can be difficult to schedule a short-notice appointment. Parents will have their child tough it out at home. But this means missing more school for the child, and more work for the parent. Or sometimes, children return to school before they are back to full health. This exposes others to the illness, and the child still won’t feel one-hundred percent better.
Denton Independent School District is trying to change this by piloting School-Based telemedicine.
This resource connects school nurses to doctors or nurse practitioners via specialized tablets. These devices help a remote physician make a diagnosis by using wireless otoscopes and stethoscopes.
Onsite nurses conduct a medical exam using wireless tools synced to the devices. The doctor on the other end can then make a diagnosis.
Parents must give consent before an appointment. They can even call into the appointment through speakerphone or attend in-person. The doctor can determine if the student should be in school or needs further treatment.
This helps save a trip to the doctor’s office and determines if a student needs to miss school in the first place.
Conclusion
Telemedicine services are becoming more popular to tackle current health issues. While they don’t always receive coverage, the government realizes this opportunity. They’re proactively working new legislation to make these services more affordable and available.
Mental health issues are increasing but providers are shrinking. Telecommunication will connect patients to care across the nation. Even if an area lacks appropriate professionals, there will still be ways to connect.
Without a doubt, the most attractive draw to these technologies is its accessibility. As the service grows in popularity, patients can connect to physicians regardless of their location. This is especially exciting for those who live in rural areas.
Never in the history of healthcare has medical attention been more accessible to patients.
