A very smart doctor told me, "there’s been a realization that the exam room is wherever the patient is."
That simple, elegant and insightful remark was offered by Dr. Jay Sanders, one of the godfathers of telehealth. I quote him here from my report published this week by the California Health Care Foundation. It’s called Right Here Right Now: Ten Telehealth Pioneers Make It Work.
This report is coupled with another by Forrester, Delivering Care Anytime, Anywhere: Telehealth Alters the Medical Ecosystem. My colleagues at Forrester, Carlton Doty and Katie Thompson, have assembled a very current look into the state of telehealth and drivers for the future.
Forrester defines "telehealth" as, "The use of telecommunications and information technologies in any area of health care, including medical intervention, prevention, care management, education, administrative tasks, and even health advocacy….It is a broader term than ‘telemedicine.’"
Forrester identifies several positive signs of telehealth adoption:
* Increased ubiquity of Internet connectivity * Medical professionals showing technology prowess * Physician and nurse shortage * Legislative pressure and payer incentives.
Of course, in the midst of techno-optimism, there are signs of barriers to telehealth adoption in:
* Low consumer awareness * Liability concerns (what else is new?!) * State licensing and regulation (always an issue in cross-border care) * Reimbursement * Data interoperability and portability.
Net-net, the near-perfect storm for the adoption of anytime, anywhere health is with us. Consumers are looking for 24×7 access for their lives, empowered by portable technology and ubiquitous wireless phones; reimbursement is beginning to align for telehealth (see my report’s discussion of CIGNA, for example, and the story of American Well in Hawaii); data interoperability is moving along, slow but steadily; and under an Obama administration and fueled by Governors’ collective appreciation for health IT as a Medicaid and the nation’s need to align incentives for Medicare, licensing and regulation will move ahead in this area. And the lawyers–well, we’ll just have to pull them along this critical path.
Jane’s Hot Points: Think about Dr. Sal Volpe, day in and day out, seeing patients and integrating new IT into his medical practice. He’s ‘doing’ mHealth — on the move, real-time, current, excellent care for his lucky patients in Staten Island, NY. He’s been morphing into a new model of a PCP on the fly, under the day-to-day pressures of practice. And with the curiosity of an adolescent with the new-new Nintendo gear.
I see all the telehealth pioneers I interviewed as lifelong learners — from the sage Dr. Jay Sanders and his son, Dr. Laurence Sanders who is striking a life-balance between his professional life and the personal — to Dr. Joseph Kvedar who continually reinvents, re-investigates, reassesses, and retools Connected Health for the betterment of patients, clinicians, and community.
Thanks to the Foundation for continuing to fund research that’s focused on the new, emerging, and practical aspects of health information technology. As Foundations and charitable organizations become more challenged in 2009 with the decline in asset values and stretched budgets, we all must appreciate what health-focused foundations do.