Telemedicine is the use of information technology such as telephone consultations, internet communications, and web-connected diagnostic devices in providing health care. Providers, for example, can monitor a patient’s weight, blood pressure, pulse, and glucose levels through devices linked to the internet, and doctors can perform consultations through video conferencing. By opening the door for more service, telemedicine can increase access to health care and cut costs through increased competition and elimination of transportation for patients who live in remote areas.
The legislation, introduced with bipartisan support in both state chambers in January, will insurance companies to cover telemedicine services if the governor signs it.
“These proposals are a positive first step that will allow millions of Virginians access to high-quality, convenient, and affordable telehealth services,” said Matt Glans, a senior policy analyst at The Heartland Institute, which publishes Health Care News. “Telemedicine allows increased access to care for the unserved while dramatically reducing health care costs.”
Filling Doctor Shortages
More than 84 million people are in primary care Health Professional Shortage Areas as defined by the federal government based on the percentage of health care professionals among the population. In Virginia, according to data listed by the Kaiser Family Foundation, there are 110 such areas, where 1.5 million people live.
Outdated laws are an important cause of the shortages, Glans says.
“The stringent licensing process has made it difficult for entrepreneurs to enter the market with new services, slowing the competitive process,” Glans said. “The new proposals directly address the licensing issue by allowing any doctor who is licensed and in good standing with the relevant regulatory agency in their home state to provide telehealth services to Virginians.”
Telehealth helps tackle problems with the nation’s overregulated health care system by improving the supply side, says Benjamin Knotts, a grassroots director for Americans for Prosperity.
“For years, we’ve been arguing the demand side of health care and who’s going to pay the bill,” Knotts said. “The patient? The government? Insurance companies? No one can afford it, because the cost is so high. We need a more unifying focus and to start thinking of ways to increase the supply. If we increase the supply, we can decrease the cost while meeting the demand.”
Glans says health care has been unduly slow in incorporating commonplace innovations in communications technology.
“The health care industry is one of the last sectors of the economy to fully embrace the potential of modern communication networks. Look at the innovation and reduced costs we’ve seen in sectors like retail and transportation,” said Glans.
Weeding Out Regulations
Technology is changing so rapidly that the best thing states like Virginia can do is remove legislative barriers to expansion of health care services, especially occupational licensing, which restricts who can practice and where, Knotts says.
“If you are licensed to provide care, you should be able to leverage cutting-edge technology to expand your service,” Knotts said. “And it is the patient’s decision. Currently, many are driving across state lines to get care, so why should they not be able to do that from the comfort of their own home?”
Both house of the legislature passed two of three components of the bills on February 4 and sent them to Gov. Ralph Northam for signature. Knotts attributes the success to bipartisan support.
“Both Republicans and Democrats like the idea of disrupting the status quo and telemedicine does exactly that because it increases access,” said Knotts.
The chambers passed measures on remote monitoring and reimbursement but deferred on the licensing component of the bill until further study. Knotts says the focus now turns to North Carolina, where a telemedicine bill failed two years ago.
“This time there will be a completely new bill, one based on our success in Virginia and tailor-made for North Carolina, and it will have bipartisan support,” he said.
Virginia is the first state to consider telemedicine involving input and support at the grassroots level, Knotts says, adding he is hopeful professional groups will see the licensing issue not as a threat but as a new way to expand their reach.
Ashley Bateman([email protected]) writes from Alexandria, Virginia.
“Primary Care Health Professional Shortage Areas,” Kaiser Family Foundation, December 31, 2017: https://www.kff.org/other/state-indicator/primary-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Percent%20of%20Need%20Met%22,%22sort%22:%22desc%22%7D