In Indiana, telehealth is redefining the practice of medicine. The technology fills gaps where access to care is limited. It reduces patient wait time and drive time for physicians. Further, physicians and providers who see patients via telehealth have improved compliance rates and reduced no-show appointments.
|Definition of Telehealth
The Medical Licensing Board of Indiana defines telehealth as “The practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, or exchange of medical education information by means of real-time video or secure chat or secure email or integrated telephony, while the patient is at any location and the health care provider is at any other location.”
Bloomington Meadows Hospital, a behavioral health facility, provides a good example. Patients present for inpatient treatment from 71 different counties. Their psychiatrists and nurse practitioners handle an average of 100 outpatient visits per week, of which 60 percent use telehealth. Most patients are children and teens. Through telehealth technology, they can continue caring for their discharged patients.
“We are just scratching the surface in terms of what we are able to do with telehealth,” explained Joshua Paul, director of Development and Partial Hospital Programs. "There are so many benefits and very little resistance.”
Additionally, Bloomington Meadows provides level of care assessments in 30 different schools and psychiatric care in four professional partnership locations.
“The best example of quality care is the pediatric office in Madison,” said Paul. “They needed additional psychiatric support for primary care. Having a telehealth presence, the physicians can refer internally to our consultation service, which has been incredibly effective for patients and ideal for us.”
Read more about Bloomington Meadows at their website.
Terre Haute family physician Randall Stevens, MD, has participated in telehealth for eight years. On a contractual basis, he provides tele-occupational health services for two local companies 24/7.
|Randall Stevens, MD, uses telehealth technology to deliver medical advice.
“Basically, I triage their employees when they are injured. I do not diagnose or prescribe, but provide advice about the need for treatment,” he said. “Through secure video on my computer or iPad, I can assess the employee and help the company decide if the employee is in need of immediate services. The cost savings to both companies has been enough to pay for the service.”
Dr. Stevens noted telehealth is an ideal tool to treat patients in rural areas.
Infrastructure should be the first consideration, according to Stephanie Laws, RN, manager of the Telehealth and Innovative Technologies Department of the Lugar Center in Terre Haute.
“Physicians should first decide if they want to do consults or diagnostics because it will determine the type of equipment they will need,” said Laws. “Medical diagnostic equipment is a little more complicated.”
According to the Wabash Valley Rural TeleHealth Network, key considerations include:
- Where will the telemedicine services be based?
- Who will head telemedicine services?
- What resources will be necessary for the telemedicine program?
- What structures need to be developed or revised?
- What business and financial planning needs to occur?
- What other part of your organization may telemedicine affect?
Read more at the rural telnet website.
The Upper Midwest Telehealth Center, also in Terre Haute, provides free resources to help you get started.
“We talk to providers about the process and how to integrate telehealth or video-conferencing technologies into their everyday clinician practices,” commented Becky Sanders, program director for the center. “We connect people with telehealth resources.”
Telehealth technologies can help physicians and hospitals reduce readmissions and avoid 30-day readmission penalties, according to Sanders. It enables physicians to meet higher quality measures and stay financially viable.
“Telehealth is being driven by patients and payment reform,” she explained. “More and more organizations are joining accountable care organizations and moving toward a risk-based shared savings reimbursement model. The Centers for Medicare & Medicaid Services is already making changes to the Medicare Shared Savings Program that provides incentives to keep patients well. As reimbursement moves away from a fee-for-service model, physicians will be incentivized to become more efficient in how they care for their patients. Telehealth can cover a lot more ground virtually and physically.”
Read more at the Upper Midwest Resource Center.
The Health Research Funding website provides the pros and cons of telehealth here.
For additional information about telehealth, go to the American Telemedicine Association.