As telemedicine programs start gaining steam outside of the rural communities that first adopted them, something has become inescapably clear: They work.
The VA's program leads the way, with statistics that confirm what many suspected about telemedicine. People prefer it (94% approval rating from patients) and it reduces office visits (by 34%). It's even good for use in mental health, with those in the VA program scoring lower on post-traumatic diagnostic scales than they did prior to their telehealth sessions. And even big states like New York are passing laws to ensure that telehealth is reimbursed by insurance companies at similar rates to office visits, to ensure that savings to providers remain intact.
There are only two elements missing, and the American Telemedicine Association is working on both of them. First, they are beginning the process of establishing accreditation standards so there is parity across the board in how telemedicine services are delivered. This move is a no-brainer, as the government will inevitably step in with some form of regulation, so it's best for the industry to start self-policing to ensure high standards of care.
The second element is the establishment of a national license for physicians so the benefits of telemedicine can cross state lines. Medical licensing was not established in the US overnight. As detailed in a recent book published by Lexington Books, Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards, the evolution of state medical licensing boards was a long load that mirrored our country's development from a young revolutionary state to a broad and complex collection of states with differing needs and standards. It's only been over the last half-century that the licensing of doctors has become crystallized as a necessary step to becoming a doctor, and the concept of telemedicine—and the current lack of primary care and specialist physicians—were not considerations when those licensing requirements were solidified on a state-by-state basis.
But today, we are in an age of national healthcare reform, and we face national crises. The lack of doctors is transcending its rural roots and raising its head in more urban areas. When the recent Ebola threat took place, doctors around the nation, and the world, responded to it. Certainly, there are times when we are a collection of states with differing needs, and times when we are one nation with a defined mission—the ACA wasn't passed with only Maryland in mind. This is one of those times when the healthcare industry and the national regulatory boards need to stand together and with one voice solve a problem that is one of the few that is easily within our grasps.
Of course, the debate over what constitutes an appropriate doctor-physician relationship in the context of telemedicine still has to be resolved—something that states are continuing to grapple with. Arkansas legislators this week rejected a bill that would have allowed Arkansas physicians to offer video-based care to state residents.
It's time for a national regulatory body to ratify a single national license for doctors to participate in nationwide telehealth programs so that the benefits and promise of this tool can be used for the benefit of all Americans, no matter where they live.