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Telemedicine Updates

Dec 08, 2022 5:25 pm

Several recent articles inform us of recent trends in Telemedicine.

Recent MMWR reports that from 2019 to 2021, the use of telemedicine increased for office-based physicians from 15.4% to 85.9%; higher among primary care physicians and medical specialty physicians than it was among surgical specialty physicians. In 2021, 91.4% of primary care physicians, 87.2% of medical specialty physicians, and 74.8% of surgical specialty physicians used telemedicine technology.  (Editors note: other reports have suggested that telemedicine use has waned significantly in the last year, making up less than 20% of all claims)

JAMA reports on a US quality improvement study involving 4066 patients showing that adding a patient navigator to telehealth visits increase visit attendance by 9%, with a positive return on investment of $11 387 over the 12-week period. The navigator contacted patients with next-day scheduled video appointments by phone to offer technical assistance and answer questions on accessing the appointment. (Editors note: this intervention addresses the most common reason telemedicine fails - patient training, setting expectations and trouble shooting the technical challenges involved in effective telehealth visits)

JAMA has also informed us of the recent Telemedicine Rollbacks—Why Providing Care Across State Lines Is No Longer as Simple as It Was Early in the Pandemic. Early on telehealth was facillitated by the Centers for Medicare & Medicaid Services (CMS) who expanded the use of telemedicine in March 2020 for 151 days (after the federal public health emergency ends (Reuters reports the public health emergency will extend beyond its current expiration date of January 11, 2023).  While Congress extended expanded Medicare coverage of telemedicine until at least June of 2023, out of state coverage for telehealth visits is quickly waning as virtual appointment across state lines has already ended for most. Medical licensure waivers have ended as each states Governors’ public health emergency declarations expired. As of November 1, 2022, only 11 states have emergence declarations still in place with most due to end within weeks or months.  Yet there are pathways to interstate practice of telemedicine according to the  Federation of State Medical Boards (FSMB).  This article should be read by those interested in continuing telehealth care, especially across state lines.

The World Health Organization has published its "Consolidated telemedicine implementation guide" for those looking to upgrade or standardized telehealth services.

The author has no conflicts of interest to disclose related to this subject

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