Telehealth Potential Remains, Trapped by Regulations and Licensure Barriers

Dr. Alan Lee's Perspective article in the December 2011 Physical Therapy journal offers hope tempered with a dose of pragmatic reality - much work still needs to be done if telemedicine techniques can be brought to bear for the benefit of physical therapists' patients.

Some of the barriers on the provider side identified by Dr. Lee include:

• licensing and credentialing - Alaska and Washington state are the only two states to include telemedicine language in their practice acts. New legislation promoting "license portability" is being prepared for the Congress in 2012.

  “Telemedicine is medicine, just practiced virtually”,

  ...said the office of the bill's sponsor, Senator Tom Udall of Utah. 

On the policymakers' side the barriers include:

• billing and reimbursement - payment for physical therapy services is currently dictated by the setting or delivery method, ie: home health, outpatient, hospital, etc,

Telemedicine's biggest benefit is probably its costs savings to both the provider and the patient.

But, new evidence that telemedicine can impact relevant patient outcomes that are "hot topics" among payers and policymakers is increasing.

Geisinger Health Plan, using telemonitoring technology, has demonstrated a 44% reduction in 30-day readmissions compared to a control group.

How Can Outpatient Physical Therapists Use TeleMedicine?

I imagine a scenario similar to the Geisinger program where patients are followed after discharge to monitor their status and identify risk factors before symptoms occurs, or before an adverse event happens.

Can you imagine Skype connection (available for free on newer laptop computers) with your geriatric patients?

What if you could measure the 10-foot Gait Velocity over Skype and predict the need for Skilled Intervention based on slowing gait speed?

What if Medicare would pay - based on this one measure alone?