Telemedicine: What the future holds

Penn Medicine associate CIO John Donohue shares insights and obstacles from the academic medical center's work on telehealth thus far. 
By John Donohue, Penn Medicine
11:06 AM
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Telemedicine has been around now for almost twenty years, so why is it not as common as sliced bread in late 2016? To be fair, the practice is growing, just not as fast as some would expect or even demand.

Delivering healthcare to remote locations is hardly a new concept. Technology advances in both healthcare and telecommunications have resulted in significant strides and evolving ways to deliver care.

It’s clear that effectively harnessing the full breadth and depth of telemedicine’s capabilities, in fact, can impact healthcare for millions of people, especially those in more remote communities and regions.

Advances already made
There are several drivers for the growth that we have seen. Convenience is certainly one of the drivers. The ability for a patient to avoid having to drive to the doctor’s office and spend time in the waiting room is another real benefit.  Also, with an effective telemedicine program, an organization can extend its reach to a much broader area and provide access to care to those that might normally be limited in terms of options.  

[Also: Precision medicine: Analytics, data science and EHRs in the new age]

There have also been notable technological advancements that advance telemedicine. Broadband and internet access is more common than ever before. Improvements in wearable devices and portable diagnostic technologies have made it possible to do more from the patient’s home. Lastly, smartphones and associated mobile applications have become available to almost everyone in this country. 

Major obstacles
What are the limitations and barriers to a full blown rollout of telemedicine across the country? 

A fistful of issues prevent us from fully realizing the potential of telemedicine. The largest, of course, is reimbursement. Bending the cost curve in healthcare is going to require the reduced costs typically associated with telemedicine programs. Limited reimbursement in today’s market has been a constraint.  This is improving over time and as the value associated with telemedicine becomes more tangible, the constraint should be less of an issue. Clinical and legal concerns are also potential issues, but healthcare organizations have been working with the appropriate local, state and federal agencies to develop workable solutions to alleviate these concerns.

Future promise
Estimates suggest that 15 million Americans received remote medical care last year and I suspect that this number will increase significantly over the next few years.

Changing reimbursement models will help drive this increase. Social factors should also influence the growth as people get more comfortable with the technology on both the provider side and the patient side of the transaction. Most organizations are looking for ways to expand their Telemedicine programs.

At Penn Medicine, we are active on the telemedicine front.  We have invested in the core technology to have a standardized approach to supporting and delivering telemedicine services.  We have built out a solution to integrate directly into the electronic medical record system for additional benefits such as having the episode be part of the patients record and automated billing. We have a number of telemedicine programs in the works with more in the pipeline.  The standardization of the technology has helped us to make the services more efficient and effective to deliver across our patient base. 

As the technology advances and the patient community becomes more comfortable with the technology, we expect our telemedicine programs to continue to grow.

John Donohue is associate CIO of technology and infrastructure at Penn Medicine.  


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