Dr. Jack Resneck Jr. (second from left) speaks at the opening session of ATA 2016.
Telemedicine has arrived, yet it has plenty more to do to prove itself.
That was the central takeaway from the opening plenary session of the 21st annual American Telemedicine Association annual conference, Sunday in Minneapolis, where leaders celebrated their progress and took stock of the work ahead.
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“This year really solidifies that telemedicine has moved from the periphery to the mainstream of clinical medicine,” said ATA President Dr. Reed Tuckson, a former UnitedHealth Group executive who’s now a healthcare consultant in the Twin Cities.
The ATA’s membership has grown from 8,500 to about 10,000 in just the last year, Tuckson noted. The organization had some success in advancing cross-state practice — a major roadblock to wider use of telemedicine — to the point that 14 states now have signed on to the Federation of State Medical Boards’ Interstate Medical Licensure Compact.
Tuckson said the ATA also has successfully worked with the Centers for Medicare and Medicaid Services to get the federal agency to waive restrictions on urban telemedicine reimbursement in the Next Generation ACO Model and in bundled payments for joint replacements. Meanwhile, the Federal Communications Commission just recently expanded its Lifeline program for low-income Americans to include support for broadband Internet, he added.
In February, National Institutes of Health Director Dr. Francis Collins announced that NIH would launch a “participants technologies center” this summer to, among other things, make telehealth part of the Precision Medicine Initiative. “We are, to say the least, very jazzed up,” Tuckson said.
Yet, there hasn’t been enough progress in the integration of telemedicine into electronic health records. “That is work that has to go on,” Tuckson said.
“Our technology challenge is around interoperability,” agreed Dr. Jack Resneck Jr., vice-chair of dermatology at the University of California-San Francisco and an American Medical Association board member. People need to be able to get medical records when and where they need it, and telemedicine reports need to get back to referring physicians, Resneck said.
Dr. Russell Holman, CMO of publicly traded hospital chain LifePoint Health, said that when his company evaluates new technology, executives look at patient safety above all, then cost, then the ability to track outcomes retrospectively. “On the clinical side, the interoperability piece is the bugger,” Holman said.
Resneck, Holman and three other physician leaders joined Tuckson in a panel discussion after Tuckson’s opening remarks. There was consensus around the idea that there’s still a shortage of clinical evidence around the efficacy of telemedicine.
“We need an evidence base,” said Resneck. “We need products that integrate seamlessly into our practices.”
Clinical validation really should be central to technology adoption on the provider side, according to Dr. Eric Anderson, chair of the telemedicine workgroup at the American Academy of Neurology. “There are a lot of people innovating for innovation’s sake,” noted Anderson, who practices teleneurology in Decatur, Georgia.
