• Arizona

    Red Tape a Major Barrier to the Use of Telemedicine, Study Shows

PHOENIX, Ariz. — Administrative burdens and limits on reimbursement are among the obstacles keeping hospitals from choosing to implement potentially lifesaving telemedicine programs, according to a study published in the January/February issue of Telemedicine and e-Health. The study by researchers from Mayo Clinic in Arizona, C3O Medical Group in Ojai, Calif., and UCLA Medical Center in Los Angeles, surveyed emergency and critical care telemedicine users to determine factors that motivate and barriers that impede development of a robotic telemedicine program.

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VIDEO ALERT: Click here to view comments about the study.

Telemedicine provides timely medical expertise to patients who have medical emergencies but do not have ready access to specialized medical centers. For instance, in Arizona, Mayo Clinic operates a telestroke program featuring a robot that allows a stroke patient in a rural emergency department the opportunity to be seen in real time by a specialized stroke neurologist at Mayo Clinic in Phoenix.

The study results are not surprising, says Bart Demaerschalk, M.D., a neurologist and professor of neurology, director of the Mayo Clinic Telestroke Program and co-author of the study. He says the study revealed that the primary impediments to continued success in telemedicine are:

  • Licensing restrictions
  • The administrative burden of giving physicians privileges and credentials to engage in telemedicine and lining up malpractice insurance
  • Limitations in ability for billing and reimbursement

"Fortunately, the majority of respondents indicated that the technology itself, obtaining buy-in from health care administrators and the culture were not barriers to telemedicine," Dr. Demaerschalk says.

And the primary motivators for providing telemedicine?

"The ability to deliver timely clinical expertise, overcoming service gaps, improving quality of care, improving adherence to guidelines of practice and patient satisfaction," Dr. Demaerschalk adds.

The researchers applauded the Centers for Medicare & Medicaid Services for a new policy that allows credentialing by proxy which, they say, has tremendously reduced the administrative burden for credentialing providers in remote areas. They also urged the development and use of interstate and national telemedicine licenses for providers and the continued lifting of reimbursement restrictions.

"The researchers in the study encourage those government and nongovernment insurers to more liberally reimburse for telemedicine consultations the same as they would for face-to-face care — particularly for acute robotic telemedicine consultations where there is proven reliability, validity, safety, clinical efficacy and cost-effectiveness," Dr. Demaerschalk says.

Mayo Clinic first used telemedicine technology with the stroke telemedicine program in 2007, when statistics revealed that 40 percent of Arizona residents lived outside areas with stroke expertise. Mayo Clinic was the first medical center in Arizona to study telemedicine to serve rural patients with strokes and today serves as the hub in a network of 10 "spoke" centers. Since the stroke program began, nearly 1,000 emergency consultations for stroke between Mayo neurologists and physicians at the spoke centers in Arizona have taken place. Beyond Arizona, Mayo Clinic Telestroke is represented nationally, with hub-and-spoke networks in Florida and in development in Minnesota and the Mayo Clinic Health System.

Media Contact: Jim McVeigh, 480-301-4222