In the first national look at how broadly web-based technologies are being used to provide health care, a University of Michigan researcher has found that 42 percent of U.S. hospitals use some type of "telehealth" approach.
The study, published in the February issue of the journal Health Affairs, breaks down adoption rates by state. It also pinpoints state policies that might encourage more hospitals to adopt telehealth.
Telehealth aims to both reduce costs and improve patients' access to care, said Julia Adler-Milstein, lead author of the study and an assistant professor at the U-M School of Information and School of Public Health.
The approach goes beyond videoconferenced doctor visits. Actually, it's very little of that, she said.
More common are services such as teleradiology, which lets remote radiologists read X-rays and other diagnostic images more inexpensively than the local going rate. Electronic intensive care units allow specialists to support ICUs in places that don't usually have enough patients to staff one full time. And telemonitoring can regularly update doctors on patients' vital signs in real time, letting them know when someone needs attention.
In a congestive heart failure telemonitoring study with 3,000 participants in Boston, hospital readmissions dropped by 44 percent, leading to $10 million in savings over six years, the new study cites.
"It's become clear that there are a lot of really valuable use cases for telehealth and that becomes increasingly true under the Affordable Care Act. It's worthwhile to think about how to promote broader adoption," Adler-Milstein said.
The researchers found a correlation between higher telehealth adoption rates and laws that require insurers to reimburse web-based services as they do in-person care. Today, 21 states mandate this and hospitals in them were one-and-a-half times more likely to utilize telehealth.
"One of the key lessons for policymakers is that broad-based reimbursement laws seem more effective than narrowly focused ones that might reimburse individual telehealth approaches such as live video," Adler-Milstein said. "None of the narrow reimbursement policies were powerful enough to have an effect."
