More Web-based Health Greatly Encouraged in Hospitals

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Based on a recent study, conducted by a researcher from the University of Michigan, 42 percent of U.S. hospitals use some form of ‘telehealth,’ method. The study is the first of its kind to scope how widely web-based technologies are being used to provide health care.

The study, which has since been published in the February issue of the journal Health Affairs, illustrates and explains adoption rates state by state. It also breaks down state policies that might encourage more hospitals to adopt telehealth.

“Telehealth aims to both reduce costs and improve patients' access to care. The approach goes beyond video-conferenced doctor visits. Actually, it's very little of that ,” said lead author of the study and an assistant professor at the U-M School of Information and School of Public Health, Julia Adler-Milstein.

More common are services such as teleradiology, which allows remote radiologists read X-rays and other diagnostic images more economically than the local going rate. Electronic intensive care units (ICU) enable specialists to support ICUs in areas that don't usually have enough patients to staff one full time. Furthermore, telemonitoring can regularly update doctors on patients' vital signs in real time, letting them know when a patient requires attention.

In a congestive heart failure telemonitoring study with 3,000 participants in Boston, hospital readmissions plummeted by 44 percent, leading to $10 million in savings over six years, the new study notes.

"It's become clear that there are a lot of really valuable use cases for telehealth and that becomes increasingly true under the Affordable Care Act. It's worthwhile to think about how to promote broader adoption," said Adler-Milstein.

The researchers discovered a connection between higher telehealth adoption rates and laws that require insurers to reimburse web-based services as they do in-person care. As of today, 21 states consent to this and hospitals in them were one-and-a-half times more likely to employ telehealth.

"One of the key lessons for policymakers is that broad-based reimbursement laws seem more effective than narrowly focused ones that might reimburse individual telehealth approaches such as live video. None of the narrow reimbursement policies were powerful enough to have an effect,” said Adler-Milstein.

One other policy that may contribute in encouraging or discouraging telehealth adoption is whether out-of-state practitioners can do business in a state without a special license. Six states forbid out-of-state Medicade practitioners from remotely treating patients within their borders without an additional license. The researchers found that hospitals in those states were almost 40 percent less likely to employ telehealth strategies.

Adler-Milstein and her team were a little surprised to find that telehealth use was common in very competitive markets.

"It seems to be something hospitals use to differentiate themselves. People often think about rural areas when they think about telehealth. And we did find that hospitals in rural areas were more likely to adopt these strategies, but the fact that adoption was just as likely in competitive markets signifies that it's not just about access. It's about using technology to lower operating costs and deliver care more efficiently,” she noted.

Alaska, Arkansas, South Dakota, Maine, and Virginia had the highest share of participating hospitals, while Rhode Island, Utah, Alabama, Mississippi and Illinois had the lowest share.

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