National Telemedicine Initiatives: Essential to Healthcare Reform

Abstract

Telemedicine technology embodies the electronic acquisition, processing, dissemination, storage, retrieval, and exchange of information for the purpose of promoting health, preventing disease, treating the sick, managing chronic illness, rehabilitating the disabled, and protecting public health and safety.Telemedicine systems consist of collaborative health networks, facilities, and organizations dedicated to these objectives.Over the past several decades, telemedicine systems have demonstrated the capacity to do the following:• Improve access to all levels (primary, secondary, and tertiary) of healthcare for a wide range of conditions-including, but not limited to, heart and cerebrovascular disease, endocrine disorders such as diabetes, cancer, psychiatric disorders, and trauma; as well as services such as radiology, pathology, and rehabilitation.• Promote patient-centered care at lower cost and in local environments that also contributes to stabilizing local healthcare and economies.• Enhance efficiency in clinical decision making, prescription ordering, and mentoring.• Increase effectiveness of chronic disease management in both longterm care facilities and in the home.• Promote individual adoption of healthy lifestyles and self-care.Telemedicine has costs and benefits.However, the benefits accruing to providers, clients, and society at large far exceed the cost.These benefits include: providing primary care physicians with ready access to specialist colleagues; extending the reach of specialist providers at tertiary care centers; integrating medical services across multiple delivery sites; obviating unnecessary patient travel to distant specialists; enabling rational triaging of patients; minimizing duplication of diagnostic tests and clinical services; stabilizing rural providers and local economies; and enhancing access to care for institutionalized populations while reducing cost and enhancing public safety.The tasks facing the nation in improving the health status of Americans through major reform of the health system are formidable.This reform must assure improved access to appropriate and quality healthcare while controlling costs.One necessary component of this reform is the provision of insurance coverage for people who are underor uninsured.However, health insurance does not guarantee appropriate access to healthcare that is not distributed equitably.Hence, we acknowledge that telemedicine is not the panacea for healthcare reform.Rather, it is a cost-effective and clinically effective solution.A cornerstone of telemedicine development rests in the simultaneous requirement of parity in reimbursement between telemedicine and in-person care.The current context for reform presents an ideal opportunity for the full-fledged integration of telemedicine in the health system, with far-reaching benefits for this and future generations.