A physician in his office consults with a specialist in another location over a secure video feed to help diagnose a patient. A doctor in transit uses his iPhone to schedule appointments, order tests and view a recent mammogram. A specialist in Atlanta helps diagnose a stroke victim in Alaska in real time, allowing for life-saving medical treatment.
All are examples of the use of telemedicine, a fast-growing healthcare field that will be the focus of the American Telemedicine Association's 15th Annual International Meeting and Exposition, held May 16-18 in San Antonio, Texas.
Benjamin Forstag, director of communications for the Washington, D.C.-based ATA, estimates there are 200 news stories a day that deal with telemedicine or telehealth, yet despite this "robust Internet press," there's very little mainstream support. He expects the interest to grow as telemedicine-themed proposals or projects become reality, and as healthcare providers and payers realize there's clinical and financial value in taking healthcare out of the realm of the hospital or doctor's office and extending it to the home or remote clinic.
"Right now, there's not one single service that you can point to and say, 'Well, that's telemedicine right there,'" he said. "The lexicon of telemedicine is huge."
Joel Barthelemy, managing director of GlobalMedia, an eight-year-old, Scottsdale, Ariz.-based telemedicine provider, sees "little pockets" of telemedicine emerging, ranging from telepsychiatry and neuropathology services to programs in businesses, schools and prisons to provide immediate healthcare over a secure communications network.
"When you have such a large shortage of healthcare providers and it's only going to get worse, the only way to meet that demand is through telemedicine," he said. "The technology changes so much about the delivery of healthcare."
"I think it's a very, very exciting time to be in telehealth," added Chris Steel, U.S. department leader for the London-based PA Consulting Group. "It's driven by the rising cost of healthcare, the patient's desire for more personalized data, the provisioning of healthcare … and the technology."
The key to the development of telemedicine may very well lie in reimbursement. While some large providers, such as Partners Healthcare and Kaiser Permanente, are actively pursuing telehealth initiatives, many networks and payers are waiting for a formula that would adequately reimburse providers for telemedicine services. Some states have gotten into the act as well. On March 2, Virginia's Legislature unanimously approved a bill that would require private health insurers, healthcare subscription plans and HMOs to cover the cost of healthcare services provided through telemedicine. Gov. Bob McDonnell signed the bill into law less than one month later, making Virginia the 12th state to mandate coverage for telemedicine.
Forstag says more than 3,000 attendees are expected at next week's ATA conference, an increase of at least 10 percent over last year's attendance figures. In addition, he said, the exhibit hall has doubled in size to more than 300 exhibitors, ranging from large telecommunications giants pitching broadband platforms to small vendors with phone-based applications.
George MacGinniss, PA Consulting's expert on UK telehealth services and a vice chairman of the Continua Alliance, sees that growth on an international scale – in Scotland, the Iberian Peninsula and Scandinavia, for instance, where projects are under way to bring specialist healthcare services to homebound and remote patients.
"Ultimately, telehealth has a finite lifespan before it becomes part of the healthcare solution," added Steel. "It's just going to be part of what is accepted as the natural process of doing healthcare."