WASHINGTON July 7, 2010 Independent analyst firm Ovum presented a webinar to present the drivers and barriers to telehealth adoption, the current competition environment, and recommendations for health-care providers and patients.
The webinar was presented by the authors of two recent telehealth reports, “Telehealth: Something old, something new,” and “Telehealth in Europe – From pilot to mainstream?” Christine Chang, presented the North American telehealth climate, while Cornelia Wels-Maug focused on telehealth issues in Europe.
Wels-Maug presented a survey that asked health organizations what their top three investments priorities were. In Europe, 7% of respondents said telehealth was one of their top three priorities, while 12% of North Americans said it was a top three priority.
The United States has federal funding in place for telehealth projects and research, and includes telemedicine in its National Broadband Plan. Americans can also receive Medicare reimbursements for telehealth services, which mainly include remote monitoring devices for senior citizen patients.
Due to Canada’s large rural population they have enacted Health Infoway, a project dedicated to smarter health service methods. Out of their 181 current Health Infoway projects, 48 directly related to telehealth.
Both countries use broadband technology to provide extended healthcare to military installations and prisons.
In the European Union each country has its own legislation for telehealth. Only France has clear legal basis for telehealth practice. According to Wels-Maug, the professional code of conduct for most countries is what determines the basis for telehealth. She said “Some countries require the physical presence of a physician or the health care provided is considered to be illegal.” Austria, Germany, and Poland are all countries that restrict telehealth services.
There are also universal barriers to telehealth adoption in both Europe and North America. Chang said the lack of a sustainable reimbursement model will cause telehealth providers to initially lose money since the equipment and infrastructure necessary to run a telehealth service is expensive. A lot of the current telehealth projects falter because they are being run on grant money for a pre-determined period of time, and cannot afford to continue services once that period ends. A lack of research is another barrier to adoption. Most telehealth providers are still in the testing stage, and health organizations are unwilling to invest in telemedicine without knowing which telehealth technologies and business models are the most effective.
Chang said “Stakeholder apprehension is the most difficult challenge facing telehealth, and will require a cultural shift to overcome.” It will be difficult to convince doctors and patients that a video consultation is equal to that of a physical consultation. Privacy concerns are data protection are also prevalent in adoption telehealth. Another problem facing adoption is licensure issues. Telehealth communication across country borders can be impossible depending on the regulations set by the countries involved. However, Chang said it is important for long-distance communication to be available for telehealth’s success. Patients are more comfortable with the doctors familiar with their health history, and could access care from their doctors while on vacation or traveling away from their homes.
Wels-Maug recommended that countries and health organizations continue to invest in clinical research to discover which practices and technologies will be the most useful in large-scale telehealth services. She also stressed the importance of winning over stakeholders, saying many were not even sufficiently aware of telehealth. Addressing ethical issues and privacy and security concerns will also make stakeholders more comfortable with telehealth.
Chang gave advice to those who want to succeed in the telehealth market. She said they would need to utilize technologies currently available, saying something like developing an iPhone application for telehealth could be a good marketable service. She also said that health organizations need to develop a sustainable business model and that these organizations should be creative. Before beginning any telehealth undertaking, she advised health providers to assess the technology involved, and make any upgrades necessary.