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The Roots of Telemedicine

What were you doing in November of 1997? Maybe you were at home on the family computer, using new technology to chat with your family or friends. It seemed pretty amazing, right? Also around that same time, these same advances emerged in the medical world, allowing patients and doctors to connect outside of the office setting in virtual space.

This new practice called telemedicine got our attention. In fact, that same year, we began covering telemedicine visits for a variety of reasons. We saw it as a promising way to provide cost effective medical care, especially for patients who had trouble getting to the doctor’s office. It could also help fill in the gaps between office visits. For example, checking in with your doctor about how well your medication is working or to discuss your treatment plan.

So, now log off your AOL account and fast forward to 2015: Health care has not quite bridged the communication gap with patients as other industries have with consumers. Despite so many new and innovative ways to communicate since the 90’s, in-person visits remain the most common way to review and discuss health information with doctors[1]. Several barriers over the past two decades have prevented a widespread use of telemedicine, ranging from the high cost of technology to privacy concerns.

What is telemedicine?

Telemedicine has been used as a pretty broad term for a few decades now, causing a bit of confusion about what it’s all about. Telemedicine, also more broadly referred to as telehealth, is the use of secure electronic telecommunications in order to improve a patients’ health. Telemedicine refers to medical services delivered through secure audio and video communications systems. Over time, doctors have adopted two types of telemedicine approaches, both of which BCBSNC covers:

Store and forward technology – Sharing medical data from one site and sending it to another through a secure technology. A doctor may review audio, video or other types of data to provide a medical opinion. These types of interactions may not be live.

Two-way interactive audio-visual technology – A live, virtual visit between a doctor and patient. This type of telemedicine visit includes both audio and visual.

What about Skype or Facetime with my doctor? Since these channels are not secure or HIPAA complaint, we don’t recommend using them.

But today, telemedicine is finally gaining momentum. Health care providers continue to adopt easier and more affordable technologies. In fact, over half of all U.S. hospitals currently use some form of telemedicine[2]. A recent study reported that half of physicians believe that digital visits can replace more than 10 percent of all of their in-office patient visits.

And North Carolina is feeling the buzz around telemedicine, too. In response, the state’s medical and pharmacy boards recently finalized new rules and guidance on how doctors should prescribe and practice medicine through the use of new technologies.

Not a Medical Speciality

Many medical professionals believe that telemedicine and telehealth technologies should be viewed as a supporting tool to care for patients. It is not its own specialty of medicine. The use of technology is determined by a doctor for the right situation, who upholds the same standard of care that you would receive during an in-person visit.

More Coverage, More Options

We’ve covered telemedicine visits since their infancy. But in light of new developments here in our state, we’ve recently expanded coverage to provide more convenient options for our customers. For example, video chat visits for psychiatry, behavioral health services, genetic counseling and other online consultations with patients are covered according your health plan.

In determining what to cover, we took a look at areas where doctors and patients seem to be finding the most value in a virtual setting. We hope that this will open the door for those who are looking for more convenient ways to get the care they need, where they need it.

Challenges and Opportunities

As a company we believe that telemedicine can be a powerful tool to communicate with patients to ensure they get healthy, and stay healthy. We like to think of it as means to receive high quality care–not an additional or add-on service.

Some health care providers have expressed concern for the continuity of care a patient receives through telemedicine, or that it might contribute to an even more fragmented health care system when patients seek care outside of a primary care setting.

Others emphasize the importance of establishing a physician-patient relationship prior to providing online medical care. Regardless of these and other concerns, many in the health care community agree that telemedicine can be an appropriate and effective way to provide care, in the right situation.

Luckily, there are more resources available than ever for doctors, hospitals and consumers on how to appropriately use telemedicine, in addition to guidance from state medical and pharmacy boards.

Telemedicine: What We Cover

Psychiatric services

• Psychotherapy

• Health behavior assessments

• Diabetic counseling

• In-patient and outpatient counseling

• Online evaluations for common health concerns, new and existing patients

• Provider-to-provider consultation

The big question is whether telemedicine will help make health care affordable. Some experts argue that access to telemedicine will only increase the use of medical services, which raises medical costs for everyone. Others argue that telemedicine can help patients seek care sooner, before it turns into a costly 1:00 a.m. emergency room visit.

Playing into all this is the fact that our health care system is moving away from transactional payments and visit volume to one that focuses on the value doctors and hospitals provide to a patient. The role of telemedicine is still unclear in this new era of payment reform. Will providers use telemedicine as a way to simply reach more patients, or will they embrace the technology as part of the overall management of a patient’s health?

The use of telemedicine hasn’t yet reached a critical mass to settle any of these debates here in North Carolina, but we’ll continue to follow this trend in order to answer these important questions.

 

[1] Salesforce, 2015

[2] American Telemedicine Association, 2015

[top image: Shutterstock]

Darcie Dearth

About Darcie Dearth

Darcie is on the public relations team here at BCBSNC, and has seen health care change drastically in the six years since joining the company. She enjoys educating North Carolinians about new programs and projects underway. When not at work, you can find her at the barn riding her Quarter Horse, Sky.

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