A new study published in the February issue of the journal Health Affairs from researchers at the University of Michigan and the Center for Connected Health at Partners Healthcare System in Boston revealed that 42 percent of hospitals in the U.S. use a "telehealth" approach.
The telehealth approach, according to Julia Adler-Milstein, lead author of the study and an assistant professor at the U-M School of Information and School of Public Health, goes beyond videoconferenced doctor visits. Instead, she says, more common services are teleradiology, which lets remote radiologists read X-rays and other diagnostic images more inexpensively than the local going rate, and electronic intensive care units (ICUs), for places that don't usually have enough patients to staff one full time.
Another common "telehealth" approach, according to Adler-Milstein, is telemonitoring, which updates doctors on patients' vital signs in real time, letting them know when someone needs attention.
In a congestive heart failure telemonitoring study with 3,000 participants in Boston, hospital readmissions dropped by 44 percent, leading to $10 million in savings over six years. "It's become clear that there are a lot of really valuable use cases for telehealth and that becomes increasingly true under the Affordable Care Act. It's worthwhile to think about how to promote broader adoption," Adler-Milstein said in a statement.
The authors of the study looked at state-by-state adoption, looking at policies that could encourage more hospitals to encourage telehealth. Alaska, Arkansas, South Dakota, Maine and Virginia had the highest proportion of participating hospitals, while Rhode Island, Utah, Alabama, Mississippi and Illinois had the lowest proportion.
The researchers found a correlation between higher telehealth adoption rates and laws that require insurers to reimburse web-based services as they do in-person care. Today, 21 states mandate this and hospitals in them were more than one-and-a-half times more likely to utilize telehealth.
"One of the key lessons for policymakers is that broad-based reimbursement laws seem more effective than narrowly focused ones that might reimburse individual telehealth approaches such as live video," Adler-Milstein said. "None of the narrow reimbursement policies were powerful enough to have an effect."
The authors of the study also said getting out-of-state practitioners to do business in a state without a special license would improve adoption. Six states prohibit out-of-state Medicaid practitioners from remotely treating patients in their borders without an additional license. Hospitals in those states were almost 40 percent less likely to use telehealth.
