D
espite the Affordable Care Act’s rocky
roll-out last October, more than 7 million
Americans have signed on for health-care
coverage through the Act as of March 31. Another
3 million have enrolled in state Medicaid plans,
largely due to a provision of the Affordable Care
Act (ACA) that subsidizes states’ expansions of
Medicaid eligibility.
A major concern accompanying implementation
of the ACA is the demand these millions of
newly insured will place on the nation’s already
inadequate physician supply.
But an article in the March 2014 issue of The
American Journal of Medicine notes that advances
in telemedicine, telehealth and mHealth (mobile
health) services can help compensate for the
physician shortage while meeting the ACA’s goal
for increased health-care
efficiency.
•
Urgent services, including telestroke and
teleburn programs that provide immediate
diagnosis and treatment recommendations to
physicians who are dealing with stroke and
burn patients in remote areas
•
Mandated services, including health care for
prison inmates
•
Video-enabled, multi-site group chart
rounds, such as Extension for Community
Healthcare Outcomes (ECHO) programs
Also driving the increased interest in
telemedicine, telehealth and mHealth services
is the increase in state laws requiring parity in
third-party reimbursement for these services,
now on the books in 19 states, including Arizona –
where the state House and Senate both passed a
parity bill in 2013, without a single “nay” vote.
In an accompanying
editorial in the March
“The shifts of the health“The Affordable Care Act
2014 American Journal
care industry into new
of Medicine, Weinstein
should expand the practice
directions to accommodate
and colleagues Ana Maria
the goals of the Affordable
and provision of heath care
Lopez, MD, MPH, medical
Care Act initiative should
director of the Arizona
expand the practice and
at a distance.”
Telemedicine Program; and
provision of health care
Elizabeth A. Krupinski, PhD,
at a distance,” states the
– Ronald S. Weinstein, MD
professor of radiology and
article, authored by Ronald
director of the Southwest
S. Weinstein, MD, and
Telehealth Resource Center;
colleagues with the Arizona Telemedicine Program
suggest that telestroke care will become “the next
(ATP). Weinstein is co-founder and director of the
teleradiology” due to telestroke’s proven ability
ATP, which is based at the University of Arizona
to provide timely, life-saving care and reduce
Health Sciences Center and has received funds
permanent disability and mortality in stroke
from the Arizona Legislature since 1996.
patients.
The term “health care at a distance” refers to:
“There are very exciting things going on in
•
Telemedicine, narrowly defined as clinical
services provided by a physician
•
Telehealth, which encompasses clinical
services provided by nurses, pharmacists and
other non-physicians
•
mHealth services made possible by the
proliferation of mobile communication
devices, including smart phones, tablets and
personal digital assistants, or PDAs
telemedicine, and more in the pipeline”“There are
very exciting things going on in telemedicine, and
more in the pipeline,” Weinstein said following
publication of the article and editorial. “Our healthcare system is changing, and people are more
interested than before in having access to health
care. Telemedicine changes the way medicine is
practiced in ways that are very appealing.”
Weinstein and colleagues point to telemedicine’s
proven track record in four categories of health
care delivery:
•
“Gap service coverage,” notably night-time
teleradiology service to hospitals in rural
communities
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