Proof Telehealth Works

By Katie Wike, contributing writer

Despite concerns with reimbursement and state licensure, the UVA Center for Telehealth is providing care to 33,000 Virginians who otherwise wouldn’t receive it

According to its website, the UVA Center for Telehealth “builds upon more than 15 years of experience in telemedicine and seeks, through the use of advanced technologies and broadband communications, to uphold the mission of the UVA Health System to advance clinical service, teaching, research, and public service.” It has been providing “clinical consultations, medical education for providers and patients, and many outreach projects occurring locally and internationally” since 1994.

According to TIME, “Through the UVA system’s Center for Telehealth, physicians from 40 specialties partner with 108 community hospitals, free clinics, schools and more to provide nearly 33,000 people with care they otherwise wouldn’t be able to acquire.”

David C. Gordon, director of the office of telemedicine and rural network development at UVA Center for Telehealth, told TIME the Center for Telehealth “saves lives, saves functions, and reduces cost.” TIME goes on to write the “Virginia Health System has reduced preterm deliveries during high-risk pregnancies by 25% via telemedical services that maintain communication between patients and physicians through technology as simple as Skype and as complicated as robotics, even when those in need are hundreds of miles away from care.”

Gordon notes much of the success of the UVA Center for Telehealth is due to the combination of the state of Virginia’s being a strong proponent of telemedicine and the slow erosion of telemedicine barriers.

Medpage Today points out two hurdles facing the UVA Center for Telehealth and other proponents of telehealth - reimbursement and state licensure. “A maze of state requirements and reimbursement hurdles are onerous for telehealth providers. Rules and state regulations ‘around telehealth have so many different definitions that's it's almost impossible to decipher what is allowed and what is not,’ said John Jesser, vice president of innovation at WellPoint.”

Medpage notes Karen Rheuban, MD, medical director at the University of Virginia's Office of Telemedicine in Charlottesville, told them “Medicare defines Scott County, Va., (population of 23,000 with one federally qualified health center) and Giles County (population of 17,000 with one critical access hospital) as urban and ineligible for telehealth payments.”

Medpage also relays the thoughts of Neal Neuberger, executive director of the Institute for e-Health Policy at the Healthcare Information and Management Systems Society, who said “there is little difference between an endoscopic surgeon viewing an exam on a screen five feet away from the patient as there is consulting via telemedicine equipment several miles away. ‘What's the difference?’ Neuberger asked. ‘There is none.’

“He also blasted state licensure laws, saying they have ‘nothing to do with science, technology, or health and has everything to do with state business practices.’”

But despite these hurdles, Virginia doctors are still ahead of the game. Former Gov. Mark Warner "blew the door open" for telemedicine when he allowed Medicaid coverage there in 2003, according to Rheuban.

“There is this perfect storm of increased demand with the newly insured, a shortage of primary-care physicians and specialists, and a need to keep costs in control,” Mario Gutierrez, the executive director of the Center for Connected Health Policy, a leading telehealth policy center, told TIME. “I think telehealth provides a real vehicle for doing that.”