#5 The Emergence of Distance Health


Extending the healthcare environment to the patient’s home has been a goal for decades. The reasons have been obvious. Removing the geographic barriers to care can result in timelier, more efficient and more optimal outcomes.  An additional advantage is that distance health technologies (also known as telehealth) can enable care for both the physically infirm and those most vulnerable to infection. These can include convenience and lowering the barrier to obtaining care as well as significant cost savings. Over the years, the barriers for making this possible on a grand scale have impeded progress. Whether it was reimbursement and payment strategies, technology platforms, devices, security, or clinician workflow and incentives, for years distance health has resided just out of healthcare’s tight grasp and standard of care.

In 2018, the prevalence of connectivity enables distance health. 

After years of trials, experiments, and modest growth, innovators from many disciplines have been addressing the demographic, logistical, financial, regulatory, and technological barriers, all while patient demand continues to surge. Experts believe the most important element, however, is the mobile technologies and the preponderance of connectivity. 80% of Americans now own smartphones and nearly 75% have broadband service connecting more people than ever before. The demand for distance health now has the global infrastructure to support and accelerate it.

Hospitals are getting ready. 90% of healthcare executives reported to have or are currently building a telehealth program. Reports also predict 7 million patient users in 2018, a 19-fold increase from 2013.
These technologies are also expanding beyond the simple two-way video platform. More patients are now equipped with attachable devices that record and report vitals or postoperative progress to doctors to regularly monitor a patient’s condition. Over 19 million patients are projected to use remote monitoring devices that feed information to their doctors in 2018.

Platforms are also being built that enable more interaction between clinicians. For example, Cleveland Clinic’s Mobile Stroke Treatment Unit is not only equipped with the tools needed to treat a patient suffering a stroke at the patient’s home, it is also equipped with a telehealth connection to a stroke neurologist and a neuroradiologist who can offer expert guidance remotely. The results have been impressive, trimming the time to treatment by 40% for acute stroke, a factor that leads to more patients that can regain the ability to walk independently.
With momentum building, experts believe that the emergence and acceleration of distance health technologies and services are assured in 2018.


Where Are They Now

As technology advances and its applications expand, the concept of distance health continues to gain traction. Though almost every state Medicaid program has some form of coverage for telehealth services, complete adoption of distance health still faces obstacles; mainly the limited coverage and payment for telehealth services by Medicare. But in October of 2018, the Centers for Medicare & Medicaid Services (CMS) proposed implementation of several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans. Under this specific proposal, Medicare plans will have broader flexibility than is currently available in how they pay for coverage of telehealth benefits, CMS stated. This proposal should support the usability and practicality of distance health technologies. 

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