Reimbursement and ther factors influence the adoption of telemedicine.
TELEMEDCINE IS BEING USED successfully across the range of healthcare delivery, from sick visits at home to intensive care in a hospital setting. Reforms are beginning to remove barriers to practice, and the technology requirements are light. Payers will benefit by helping to drive telemedicine forward.
"There is a world of difference today in the acceptance and interest in telemedicine compared with even 10 years ago," says Linkous. "But of course we're not completely there yet."
"The patient is going to be the new provider," says Drazen. "All the data show increased demand for care and increasing costs, without a concomitant increase in number of providers. Some of these tools, like the home monitoring tools, are intended to help patients take care of themselves."
Blue Cross and Blue Shield of Minnesota (BCBSMN) tested telemedicine's promise in 2009 with a program for its own employees. It launched a direct-to-consumer telemedicine model a year later, followed by a model for employer sponsors.
The consumer model, Online Care Anywhere, can be accessed statewide by members and nonmembers from home. Minnesota's broad telemedicine laws helped BCBSMN move forward.
"Minnesota as a marketplace is very progressive," says Kathy Dunmire, vice president of product management. "We were early adopters of retail clinics, which have become a standard way to receive care. We see potential for virtual visits to have that same adoption curve over time."
BCBSMN wanted to change both the reimbursement model and the care delivery model. Online Care Anywhere is available to anyone in the state. Patients click into the online care Web site for the virtual visit, register, and see a doctor immediately with a credit card charge of $45.
"The member and the nonmember pay the same rate in this direct-to-consumer model," says Dunmire. "In the employer subscription model, the employer pays a subscription price, and their employees and family members have unlimited access to free online visits."
Some employers have set up an online care room, for employee privacy, with a computer and video camera. BCBSMN also has biometric equipment in its employee room (for blood pressure, weight and pulse) so an employee can conduct the consultation there.
"The economics of that work very well for an employer," says Dunmire.