Wednesday, March 30, 2011

Telemedicine Issues Discussed

A Symposium held in Washington D.C on March 10, 2011 “Balancing Access, Safety, and Quality in a New Era of Telemedicine” hosted by the Federation of State Medical Boards discussed telemedicine’s future and the impact on healthcare.

About 100 participants spent the day exchanging ideas in both large and small group sessions focusing on technology, technology issues relating to patients, providers, and payers, and the role that state and federal policy should play in determining telemedicine’s future.

Vanessa Orlando, Executive Director, of the Rural Maryland Council and Jennifer Witten, Director of Government Relations for the American Heart and Stroke Association recently submitted their summary of the “Thinking Points” presented at the symposium.

Dr. Sachin Jain, Senior Advisor in the Office of the Administrator at CMS in his keynote address discussed the barriers to hindering the development of telehealth. According to Jain, although some of the providers are hesitant to adopt and use technology, the availability of technology is not really the problem. The real issue is reimbursement which has played a much more major role in slowing the adoption of technology.

Added to these problems, the culture in medical education and practice does not encourage physicians to embrace technology. Medical education still follows the traditional method of academic instruction that emphasizes a hands-on model with patients with the result that physicians are not infusing technology into their practices.

Dr Jain mentioned that several gray areas need to be addressed such as major concerns related to licensing and credentialing. It was also mentioned several times at the symposium that it is imperative that licensing and credentialing needs to be made easier, faster, and portable with a comprehensive verification system put in place.

Also, if care is provided across state lines then reimbursement issues must be addressed. Questions are being asked as to which state would be the disciplinary body if several states are involved, how to deal with differences in background standards and practice standards, and how to develop a common language with national definitions of certain words and phrases.

One important question asked is if a critically ill patient is transported to another facility and/or a facility across state lines—then what are the liability issues? Another panel tackled the issues of access, safety, and quality in telemedicine.

One important point was made that telemedicine doesn’t always result in an overall cost savings. Although it often increases access to care for more people and may reduce the per-person cost, using technology does not always reduce over-all costs.

In addition to the “Thinking Point” document recently released, the Federation of State Medical Boards (FSMB) plans to publish a white paper complete with the full scope of the symposium discussions.

The FSMB is also in the process of developing an action plan that is based on the ideas and feedback presented at the break-out sessions. Go to to view the “Thinking Points” summary and other available reports and statements.