- The American Telemedicine Association (ATA) has released new practice guidelines on stroke assessments and mental health services for children and adolescents via telemedicine.
- Both sets of guidelines were developed by expert workgroups based on clinical and empirical research.
- They "advance the science of and growing need for telemedicine and help ensure uniform and effective quality of services for patients in need of these health-enhancing, life-saving services,” ATA CEO Jonathan Linkous said in a statement.
As use of telehealth has grown, so has the pressure for an evidence-based framework for negotiating digital doctor-patient encounters.
A 2016 study in JAMA Internal Medicine found significant variations in adherence to clinical guidelines for urgent care provided by telehealth vendors. Of 599 telehealth cases analyzed, nearly 24% involved missed diagnoses, and some care providers got it right less than 66% of the time.
The telestroke guidelines cover assessment, diagnosis, management and remote consultative support for patients experiencing signs or symptoms of stroke. It also includes guidance on administrative and technical issues. The telemental health guidelines describe how to provide mental and behavioral health services to youth using real-time videoconferencing.
In June 2016, the American Medical Association adopted ethical guidance on how physicians should interact with patients when they do so via telemedicine instead of a face-to-face visit. Informing patients about the limitations of the relationship and services provided and advising them on arrange needed follow-up care were among the recommendations included in the guidance. The guidance "recognizes that telemedicine is a tool, not a separate medical practice, and should be held to the same standard of care that governs bricks-and-mortar medicine,” Henry DePhillips, chief medical officer of telemedicine company Teladoc, recently told Healthcare Dive.
With 30% of Medicare payments already tied to alternative payment models and the HHS calling for 50% by the end of 2018, care providers are looking for ways to boost care quality and access while reducing costs. Many see telemedicine as a vehicle for change.
“You’ve got to start changing mindsets now because when you get to that magic tipping point from fee-for-service to value-based care, you better have solutions like telehealth which can significantly reduce your operating costs as well as grow your system to scale,” Tripp Jennings, chief value and informatics officer at Palmetto Health in Columbia, SC, told Healthcare Dive.
Most (83%) of surveyed healthcare executives plan to invest in telehealth this year, and 98% feel telehealth services give them a competitive edge over organizations that don’t offer them, according to the recently released ATA Leadership Survey. In addition, 84% said that offering telehealth services strongly expanded an organization’s coverage and research. The chief barriers to greater adoption of telehealth are reimbursement and licensure requirements, which vary by state, the executives said.