Update (June 6, 2018): The VA MISSION Act was signed into law today.
A bipartisan bill, the VA MISSION Act, progressed quickly through Congress and is projected to be signed into law by the president at any moment. While the bill primarily provides $51 billion in funding to support the Department of Veterans Affairs (VA) and veterans’ ability to visit private-sector physicians, a sizable clause has huge ramifications for the future of telehealth.
Among vets, rates of homelessness, suicide, mental health issues, and substance abuse far exceed the national average. Seeking care is rife with stigmas, and this shamefulness is a major barrier to seeking appropriate care. These afflictions are compounded by a scarcity of care at VA facilities — the average wait time is 26 days for mental-health evaluations — or logistical difficulties such as transportation.
For veterans, there is hope in telehealth. In 2016, 702,000 veterans, or 12 percent of America’s veterans, engaged in 2.17 million telehealth visits. Among this group, hospitalizations decreased 31 percent and decreased by 39 percent. The data collected even demonstrated that PTSD counseling using telehealth technology is equally effective as in-office visits.
Telehealth ushers in a new era of the house call, and veterans are one group among many who will benefit exponentially from advances in this field’s technology and legislation. The benefits and applications are many: greater flexibility, increased revenue, reduced office costs, and a healthier work-life balance for physicians and patients alike. Along with veterans, there are many other groups of patients who stand benefit substantially from telehealth.
With the advent of telehealth, you can have a long-distance relationship with your patients. You’ve spent years cultivating a trusting doctor-patient relationship, so why should a move out to the country—or even across the country—jeopardize that? As rural hospitals close, as 83 have since 2010, the primary care relationship becomes all the more important. Out in the country, patients must set aside large swaths of time for transportation, which can lead to last-minute cancellations and no-show visits that cost your practice serious money. Telehealth removes these barriers, saves your patients time, reduces no-shows, and boosts your billing. Furthermore, the Centers for Medicare and Medicaid Services (CMS) recently unveiled a forward-looking plan to “reduce some of the barriers to telehealth such as reimbursement, cross-state licensure issues, and the administrative and financial burden” in order to increase telehealth’s prevalence in rural areas.
Though senior patients are generally regarded as less tech-savvy than their younger counterparts, a recent survey discovered that 67 percent of patients over 60 carefully consider a practice’s digital presence in making their medical care decisions. One prominent use of telehealth is medication management and many elderly patients have specific, complex medication regimens. A telehealth visit is the perfect opportunity to review their adherence, correct any mistakes, and field questions about the symptoms to determine if any adjustments should be made. Another trend is a “telestroke” visit in which patients who experience symptoms of a stroke or heart attack can instantaneously consult their primary care doctor to determine their emergency course of action. This application is especially useful to female patients, who experience different symptoms of coronary disease than men, a phenomenon called the Yentl Syndrome. Doing so can save lives, avoid costly ambulance and ER fees, and provide peace of mind while fortifying the doctor-patient relationship. Finally, today’s high-resolution displays and technology allow for a face-to-face visit that senior patients desire without the logistical hassles like mobility and transportation that prevent them from stepping into your office.
Pediatric Patients and Their Families
When providing care to children, the patient-doctor relationship is accompanied by the relationship between the doctor and the guardian. In a controlled study, parents who used telehealth to manage their children’s conditions reported higher levels of self-efficacy and enhanced parenting practices, both of which are key in abiding by doctor’s instructions. Telehealth is a healthier choice for their children, too. Before the age of five, the average child spends 30 hours in well-child visits alone. Telehealth could supplant these in-office visits which risk exposure to sick patients. Be sure to let parents know that 97.5 percent of parents who used telehealth visits for their children reported the visit was as good — or better! — than an in-office visit.
What’s Next for Telehealth?
As the VA MISSION Act makes evident, telehealth is gaining traction. The act also stipulates that the VA assemble a report within one year that documents telehealth’s effects on patient wait-times and healthcare utilization, among other criteria. This aggregated data will surely yield further insights into and added uses for this incredible technology. Furthermore, the clause “would create a new authority to allow VA healthcare professionals to practice telemedicine regardless of the location of the provider or patient.” This bylaw sets a strong precedent and spurs the removal of barriers that have historically hindered telemedicine’s progress.
Want to learn more about telehealth and how it can serve your patients? Listen to our discussion with Dr. Vaishali Geib on our podcast, The Break Room.