elemedicine is a booming sector of the healthcare industry:
Investments are ramping up as health systems fine-tune their EHRs, explore
remote patient monitoring and look toward population health management.
But with this growth comes a need for guidance and
regulation. Nearly everyone agrees this is necessary, but issues — including a
lack of data, interoperability problems and segmented interests — present
obstacles.
Now, work is under way on developing evidence-based clinical
guidelines for providers and hospital systems. Leaders from multiple sectors of
the industry have been tapped to work on what the guidelines should include and
how they should be maintained.
These guidelines should focus on encouraging cooperation
among organizations, Dr. Judd Hollander, an associate dean at Thomas Jefferson
University who has led telehealth initiatives, told Healthcare Dive. But they
should also remember that in the end, telemedicine has the same goal as all other
medicine.
“We don’t need different guidelines for telemedicine,"
he said. "We need to achieve the goals in a different way."
Why guidelines are a must
At the recent American Telemedicine Association (ATA) annual
conference, it was hard to find a panel that didn’t touch on the lack of
clinical guidelines in the field of telemedicine. Along with the hype of new
devices and improved cloud programs, an underlying trend was that the field can
get more respect from others in the industry — and patients — with more
evidence-based guidelines.
Steven Waldren, director of the Alliance for E-health
Innovation at the American Academy of Family Physicians, said one reason
guidelines are needed is that telemedicine training is still rarely included
for up-and-coming doctors. And older doctors are even less likely to have had
exposure to such training.
There are also legal reasons. When dealing with liability
concerns, the standard of care must be crystal clear. Otherwise, doctors will
be especially conservative in their treatment for fear of getting sued, Waldren
said.
Mostly, doctors need to be armed with enough information to
be confident in the telemedicine they are practicing, he said. “I think that
the key issue is, 'Can I meet the standard of care with the level of tech I
have in a virtual visit or not?' And the doctor has to make that decision.”
Currently, most of the guidelines that exist are too broad
and simple, Hollander said, such as making sure you have a good video
connection. “That’s not really useful," he said. "That’s common
sense."
Obstacles in the way
Although telemedicine practices can yield mountains of data,
the relative youth of the field means that not enough evidence is available to
write guidelines that meet physicians’ standards. That can require many years
worth of data gathering because guidelines must be rigorous and backed up by
plenty of evidence.
