So what is “telehealth?” California’s new telehealth law (AB 415) redefines it as:
“The mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.”
California’s new telehealth laws includes email and telephone communication. Both real-time (“synchronous”) and time-delayed (“asynchronous”) electronic communication are also included. Email or telephone telehealth is not a mandatory plan reimbursement, but plan reimbursement is now more possible. Verbal consent now adequately authorizes California telehealth services. Prior Medi-Cal restrictions on implementing telehealth (ex. establishing a barrier to face-to-face visits before telehealth authorized) were removed.
Is something new afoot? Yes and no. Telehealth is not a new idea. In 1996 California was the first state in the US to pass legislation (the Telemedicine Development Act of 1996) establishing telemedicine as a legitimate method of delivering health care (but with limited reimbursement provisions). The Department of Health & Human Services/Medicare has experimented with telemedicine projects to deliver medical services to underserved/rural areas lacking sufficient medical infrastructure. But, like California, Medicare does not broadly reimburse for telephone or email or other telehealth services.
Telehealth is not new. But there is a renewed and historic effort by governments to reduce medical entitlement costs and achieve improved primary care outcomes so we slow down plan (i.e. Medicare) utilization. Why? Because if we don’t get healthier more efficiently, Medicare goes broke funding too much hospitalization and expensive medical intervention. The Department of Health & Human Services (HHS) is trying very hard to generate innovative methods to more efficiently delivery primary care: incentivized electronic medical records platforms to improve physician/patient communication and information management; accountable care organizations intended to compensate hospital/physician teams for decreasing hospitalization while better tracking patient information; and telehealth certainly fits right in with this effort. Makes sense. But does it also make “cents”–are we feasibly solving the underlying primary problem? […]