According to the 2011-2016 Texas State Health Plan undertaken by the Statewide Health Coordinating Council (SHCC), Texas is faced with tremendous population growth which means that the number of current healthcare providers simply can’t keep pace with the rate of growth.
Problems exist since the high birth rate demands more obstetricians, midwives, nurses, and pediatricians and to compound the problem, the number of pediatric sub-specialists in the state is dramatically below that of the U.S. as a whole. At the other end of the age spectrum, there is an ever increasing number of Texans 65 and older with remarkable longevity in spite of their poor overall health status and many are faced with a number of chronic conditions.
The distribution of healthcare practitioners across the state has border and rural areas facing the greatest shortages in the number of health professionals. Added to these problems, regulatory barriers have prevented the deployment of telemedicine and other technologies in medically underserved areas, whether urban or rural.
The Texas plan stresses that to meet the state’s healthcare needs, the state must embrace a serious re-prioritization of resources in health education and that the education must be inter-professional and interdisciplinary with Graduate Medical Education programs placed at the top of the financial priority list. Texas must align desired health outcomes with financial incentives and rewards for those practitioners demonstrating evidence-based practice and desired outcomes. In addition, priority must be given to maintaining wellness, stressing prevention and education, and to effectively managing chronic diseases.
The vision for the future is to have a healthcare delivery system operate as a shared community responsibility. This will require the state leaders in healthcare to stretch their imaginations and comfort zones to embrace new technologies and new models to be used to practice medicine in today’s environment.
SHCC’s Technology Committee is studying how technology can best be used to solve healthcare issues in the state. The Committee examined the ways that health IT namely electronic medical records, telemedicine, and the development of the health IT workforce could be effectively used to improve the delivery of medical treatments.
The Committee found that only a small number of Texas physicians use telemedicine services. This is according to the Texas Health and Human Services Commission’s (HHSC) end-of-year report to the state legislature on the effects of telemedicine on the Texas Medicaid program. According to that report, this may be attributed in part to the way healthcare providers report the use of telemedicine services.
The HHSC’s report suggests boosting the use of telemedicine by reimbursing for more types of medical services provided through telemedicine, expand the number of approved patient-site healthcare providers, remove limitations on telemedicine providers, add reimbursement of a facility fee payable to the patient site, and allow patients to receive telemedicine services at local health departments.
The Texas State Health plan points out that state hospitals, health plans, healthcare institutes, health carepayers, and service organizations are increasingly rethinking their traditional models for providing healthcare and so today, the focus needs to be on the development of next-generation telemedicine tools and technologies.
Next generation tools and technologies should extend the telemedicine model to include cell phones and internet-based telecommunications tools for remote and home health management with video assessments possible, remote bedside monitoring, and patient-specific care tools complete with event logs, patient electronic profiles, and physician note-writing capability.
The 2011-2016 Texas State Health Plan was submitted to Governor Rick Perry to help address issues in the current legislative session. To download the plan, go to www.dshs.state.tx.us/chs/shcc/reports/SHP2011-2016.pdf.
