Reimbursements red herring, trust, and key infrastructure needs for Telemedicine success
Telemedicine is a growing part of modern healthcare, and could play a pivotal role in the U.S.’s efforts to streamline and expand preventative services. Virtual, video-based doctor’s appointments can help alleviate the general practitioner shortage, and encourage preventative care. They also offer a cheaper, more-convenient alternative to in-person appointments for many patients. Unfortunately, there’s a lot of hype and misinformation being reported so I was pleased to see that TechnologyAdvice (TA) surveyed 504 U.S. adults about telemedicine and their willingness to use such services. I think the results shed important light on where healthcare providers and telemedicine vendors still need to gain acceptance with patients so I reached out to Cameron Graham, Managing Editor at TA to see if he can give us the facts on the ground. Cameron heads market research for healthcare IT, business intelligence, and other emerging technologies and is uniquely qualified to help shed some light on the subject. Here’s what Cameron said:
- It’s not just about reimbursements
Despite the promise of telemedicine, the vast majority of Americans still aren’t using such services. One oft-cited reason for this is the lack of insurance reimbursement for many telemedicine procedures. While some private insurers will cover telemedicine, many only cover select types of visits or specific applications. Medicare for instance covers face-to-face interactions, but only when the originating site (point of care, not the patient’s home) is in a Health Professional Shortage Area (HPSA). Although coverage is slowly improving in many states, the American Telemedicine Association gives just five states (plus DC) an A grade in coverage and reimbursement.
However, the current hodgepodge of reimbursement rules is not the only thing holding back telemedicine from widespread use. An equally important factor is likely Americans general comfort with video-based platforms, and their trust in remote appointments. According to our study, less than half of adults (44.9%) said they would be comfortable conducting a doctor’s appointment over video. Only 35.3% of respondents said they would choose a video appointment over an in-person one. Until patients are more comfortable with the notion of remote care, it is unlikely that telemedicine will gain significant traction.
In order to facilitate acceptance of telemedicine among Americans, providers and vendors need to work on educating patients about the benefits of such systems. Telemedicine vendors in particular should help patients navigate the complex reimbursement rules currently in place, and promote the cost-savings of remote appointments. By doing so they will not only gain brand awareness among patients, but will be able to recruit patients as advocates for more comprehensive insurance reimbursement policies.
- Trust is a key component of effective telemedicine
Americans are not only hesitant about scheduling telemedicine appointment, they are also skeptical about diagnoses made through video platforms. Forty-five percent of respondents said they would trust a virtual diagnosis less than one made in person. An additional 29.3% said they simply would not trust a virtual diagnosis. This suggests there is a distinct lack of trust among Americans in the quality of medical services that telemedicine platforms can provide.
Much of this skepticism is likely due to a lack of familiarity with the services. It also reinforces the fact that telemedicine providers must earn patients trust before they can effectively increase adoption rates. Once that trust is established, it appears people are far more likely to consider using remote appointments. While initially only 35.3% of respondents said they would choose a virtual appointment over an in-person visit, 65% of respondents said they would be more likely to conduct a virtual appointment if they have first seen the doctor in-person.
It’s unlikely that providers or vendors will be able to dramatically change such preferences given the personal nature of many medical visits. However, increased awareness about the qualifications of physicians could make potential patients more comfortable about conducting preventative care via video. Incorporating a rating system, or minimum quality threshold for participating physicians is one potential solution.
- Personal and professional infrastructure is key
The personal infrastructure for telemedicine is already in place across much of the United States, in the form of video-enabled smartphones. According to the latest PEW research, 64% of Americans own a smartphone. In theory, this provides them with the basic means to access remote, video-based health care. Smartphones will likely serve as first means of exposure to such services for many people.
More advanced, capable systems (such as dedicated telemedicine kiosks) however are far from established. Aside from a few test programs in select areas, there is no nationwide, professional infrastructure or technology for telemedicine. This hinders adoption and limits the use of telemedicine to basic, preventative care that can be conducted entirely remotely. Dedicated kiosks can greatly expand the use-case for telemedicine, by incorporating sensors, multiple cameras, and other advanced technology. Further investment from telemedicine vendors and insurance companies could help to boost the nationwide profile of telemedical services, and expand access for many Americans.