The New England Journal of Medicine Looks at the State of Telehealth | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

The New England Journal of Medicine Looks at the State of Telehealth

July 16, 2016
by Mark Hagland
| Reprints
The analysis in The New England Journal of Medicine of telehealth looks at some of the challenges and opportunities facing the developers of telehealth initiatives

The widely regarded New England Journal of Medicine on July 14 released online an article reviewing the “State of Telehealth,” authored by E. Ray Dorsey, M.D. and Eric J. Topol, M.D. The eight-page article focused on three broad trends that the authors see as shaping the trajectory of telehealth activity in the United States.

“The first” of the three trends, Drs. Dorsey and Topol state, “is the transformation of the application of telehealth from increasing access to healthcare to providing convenience and eventually reducing cost. The second is the expansion of telehealth from addressing acute conditions to also addressing episodic and chronic conditions. The third,” they say, “is the migration of telehealth from hospitals and satellite clinics to the home and mobile devices.”

As the authors note, “Just as the motivation for telehealth is expanding, so are its applications The earliest applications for telehealth were for acute conditions, such as trauma and stroke. In 1999, ‘telestroke,’ the provision of acute stroke care from a remote neurologist to a patient in an emergency department, was introduced to increase access to a highly effective time-sensitive fibrinolytic therapy (tissue plasminogen activator). In just 15 years,” they point out, telestroke became mainstream, and the largest care provider for patients with stroke in the country is now not a major medical center but a telemedicine company. More recently, telehealth has expanded, by means of diverse care models that include school visits by medical assistants, video calls, telephone calls, and online algorithms, to include care for episodic conditions, such as sinusitis.”

In looking at the third trend, the authors note that “Initial telehealth applications delivered care to patients in institutions such as hospitals and satellite clinics, which frequently required expensive technological systems and on-site clinical or technical support. With increasingly available broadband and portable diagnostic technologies,” they emphasize, “telehealth is rapidly moving to the home. For persons with chronic conditions, including the 2 million elderly persons who are essentially homebound, the patient-centered medical home will increasingly be the patient’s home.”

Among the key issues the authors look at are the limits and fragmentation of current insurance coverage for telehealth; issues around the quality of the patient-physician relationship, and fragmentation of care among multiple providers, and the potential for abuse (e.g., via the overprescribing of narcotics), legal issues, including state licensure laws and credentialing issues; and social issues, including the digital divide between middle-class patients with easy access to the Internet, and economically disadvantaged patients lacking that access.

Still, they conclude, “Despite financial disincentives and substantial barriers, telehealth continues to grow and is likely to spread over the next decade. The increasing number of reimbursement models will provide fertile ground for the growth of telehealth…” And, they say, “Evidence abounds for the proximity of a ‘tipping point’ in telehealth, in which adoption moves beyond early adopters, who are focused on the technology, to the majority, who are focused on pragmatic applications.”

 

 

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Study: EHRs Tied with Lower Hospital Mortality, But Only After Systems Have Matured

Over the past decade, there has been significant national investment in electronic health record (EHR) systems at U.S. hospitals, which was expected to result in improved quality and efficiency of care. However, evidence linking EHR adoption to better care is mixed, according to medical researchers.

Nursing Notes Can Help Predict ICU Survival, Study Finds

Researchers at the University of Waterloo in Ontario have found that sentiments in healthcare providers’ nursing notes can be good indicators of whether intensive care unit (ICU) patients will survive.

Health Catalyst Completes Acquisition of HIE Technology Company Medicity

Salt Lake City-based Health Catalyst, a data analytics company, has completed its acquisition of Medicity, a developer of health information exchange (HIE) technology, and the deal adds data exchange capabilities to Health Catalyst’s data, analytics and decision support solutions.

Advocate Aurora Health, Foxconn Plan Employee Wellness, “Smart City,” and Precision Medicine Collaboration

Wisconsin-based Advocate Aurora Health is partnering with Foxconn Health Technology Business Group, a Taiwanese company, to develop new technology-driven healthcare services and tools.

Healthcare Data Breach Costs Remain Highest at $408 Per Record

The cost of a data breach for healthcare organizations continues to rise, from $380 per record last year to $408 per record this year, as the healthcare industry also continues to incur the highest cost for data breaches compared to any other industry, according to a new study from IBM Security and the Ponemon Institute.

Morris Leaves ONC to Lead VA Office of Electronic Health Record Modernization

Genevieve Morris, who has been detailed to the U.S. Department of Veterans Affairs (VA) from her position as the principal deputy national coordinator for the Department of Health and Human Services, will move over full time to lead the newly establishment VA Office of Electronic Health Record Modernization.