Two interesting developments in telemedicine punctuated the runup to Independence Day celebrations last week. CMS proposed adding more telemedicine codes that can be reimbursement, primarily in the realm of psychotherapy and psychoanlysis. Humayun Chaudry, CEO of the Federation of State Medical Boards, said the group is readying a compact that would make it easier to practice medicine across state lines with participating states. He expects the proposal to be ready to be reviewed by state medical boards at the end of the summer.
Telemedicine startup and DreamIT Ventures accelerator grad 1DocWay works with physician networks and psychiatric hospitals to provide telepsychiatry services for Medicare and Medicaid patients. For co-founder and CEO Samir Malik, every development is reason for encouragement. Of the two proposals, the compact from the Federation would have the biggest impact, if it succeeds. Although the CMS proposal would have a negligible impact on 1DocWay’s sales, it’s certainly a positive step.
“Each time a piece of legislation comes out or there’s some big investment in telemedicine, it adds a little more momentum on the sales side,” said Malik in a phone interview. He added that it’s also important for telemedicine critics because it shows that it’s not just a flash in the pan. “It makes it just that much easier to go to clients and show the progress being made.”
Still, 1DocWay’s business model is focused on the regulatory reality on the ground, not what it will be a few years from now. Building alliances with physician networks in each state is central to its business model and makes a big difference because soon after they do, Malik said, the company becomes a known quantity. It becomes a service that is offering access to doctors that are familiar in that state to the residents they’re serving. “Once we are in a state, things tend to move very nicely.”
The states where it has built a presence have substantial rural communities with limited easy access to psychiatrists. Among them are Texas, Illinois, Missouri and more recent additions in New Mexico, Indiana and Kansas. To date it has treated 10,000 patients. Among the regions on its radar, states in the South are a priority. It is planning to expand to Minnesota, Nevada, Louisiana, North Carolina and Virgina.
Asked how the company defines success, Malik said providing access to care is an important measure. Another good sign — follow-up visits account for 85 percent of its business. So it’s conquered part of the biggest challenge for telemedicine companies, especially in the mental health space, where a lot of little companies are still trying to solve the question of how to attract repeat business and maintain patient engagement.
Malik said its service tends to be used to treat people with mood disorders and anxiety disorders, as well as people with substance abuse challenges. About 90 percent require some kind of medication.
One interesting development is the company has attracted interest from at least one pharmaceutical company. It is working with the company that’s interested in reaching under-served communities and wants to improve their understanding of this demographic.
In a recent phone interview, Chaudry said the idea for the compact only became a reality in January last year. “This is the first time a comprehensive licensure has been undertaken by a majority of states in this nation. What the compact is trying to do is figure out what conditions the states could agree on to provide an expedited license.”
The compact as currently envisioned requires physicians to declare a principle state of licensure and that would be where the physician lives or primarily practices. The principle state would be tasked with checking the credentials of those physicians and doing the legwork for obtaining licenses for that physician to practice in other states. Only about 16 percent of physicians have a medical license to practice in more than one state, so the proposal, if approved, could have a huge impact on the evolution of telemedicine in the U.S.