Telemedicine

At the 2018 Insurance Rehab Synergy Group Annual Conference, a panel discussed the use of telemedicine. The panel included:

• Mark Johnson – Sedgwick (moderator)
• Teresa Bartlett, MD – SVP and Senior Medical Officer, Sedgwick
• Alan Lee, PT, DPT, PhD, CWS – Professor, Mount Saint Mary’s University
• Ted Jeffries – Director of Claims, Missouri Employers Mutual

Telehealth really started in the military. There was not an expert available in the field all the time when needed so the physicians communicated with the field operatives to assist them in stabilizing and treating the patients.

Telehealth is also very common in cancer care in the group health setting as there are not experts available in all areas of the country.

Telehealth is becoming very widespread in the group health setting with one large California health system having over 1 million telehealth visits last year.

Patient satisfaction with telemedicine is very high. Many patients actually prefer telemedicine to an in-person visit because of the ease of use and no travel/wait time.

When developing a telehealth model it is important to work with the physicians to make sure they have the appropriate support to make this function. Essentially, everything should work like an office visit with the exception of the time with the physician. Their support staff should coordinate all the logistics. It is also important to screen the patients to make sure the visit is appropriate for telemedicine. Not every patient interaction is.

One myth of telemedicine is that it should be “cheaper” than seeing a patient in the office. This is just not true. You are still using the physician’s and staff’s time with the appointment and they need to be compensated accordingly. Telehealth is more convenient for patients as it saves them the travel and wait time for appointments.

Another myth is that this is just FaceTime with the doctor. It is more than that. It must be HIPAA compliment and often involves the patent being at a location with a nurse who can take vital signs etc.

Physical therapists are now using telemedicine for follow up visits with patients to monitor their self exercise program. Those self exercise programs are an important part of any physical therapy program.

Telephonic nurse case triage is a variation on telehealth where the nurse takes the initial claim report talking to the injured worker and conducts a telephonic screening to direct them to a medical provider or advise on self-care.

One of the challenges of telemedicine is dealing with different state regulations. Medical providers must be licensed in the state they are rendering services and workers’ compensation fee schedules at times to not allow for telemedicine visits.