Posted March 21, 2019
by Beau Benson
As 2019 moves into its second quarter both the United States Congress and state legislatures are beginning to pass laws introducing the expansion of reimbursement parity for telemedicine, including recent developments around expanding the list of eligible originating sites to include such locations as schools, the patient’s home, or eliminating the restriction altogether (as Arizona is expected to do with the passage of SB1089).
Legal and Reimbursement Expansion
As these laws are passed and enacted, and as commercial health plans expand their coverage, the burden to justify reimbursement for qualified telehealth services through accurate coding and documentation will fall upon the providers and their telehealth technology. To this end, integration between the telehealth technology and the provider’s Electronic Health Record (“EHR”), the patient’s portal, Health Information Exchanges (or Health Information Networks), coding systems, claims clearinghouses, billing groups, and other stakeholders will become a necessary consideration for the deployment of telehealth services.
The increasing number of remotely conducted patient visits will necessitate the inclusion of telehealth technology vendors within the scope of government regulatory legislation to which providers will attest. Virtual “visits” of certain clinical observations will require submission to public health or specialty registries (like IRIS or PRIME for ophthalmology, for example).
As telehealth moves into the mainstream as an extension of, a supplement to, or replacement of traditional in-person visits, data integration will begin to move to the forefront as a prerequisite for any new telehealth initiative. To quote Andrew Watson, M.D., Vice President, Clinical Information Technology Transformation, International Division and Medical Director, Telemedicine, UPMC and current President of the American Telemedicine Association:
“From a small system to national payer, the integration of telemedicine is 1) inevitable and 2) critical so as to not distract from current workflow. This powerful journey of healthcare transformation intersecting with the consumer electronics market will force telemedicine interoperability. But these two entities must be forced to seamlessly interact.”
As EHRs became ubiquitous in the 1980s and 1990s and then required in the 2000s, infrastructure to facilitate the exchange of healthcare data was often not built in until the Office of the National Coordinator for Health Information Technology required it through the HITECH Act and subsequent legislation, leading to unnecessary cost and inefficiency being endemic to the EHR landscape.
Learning from the Past
In 2019 telehealth vendors stand on the verge of the elimination of reimbursement and technology capabilities as barriers to adoption, similar to where traditional EHR vendors stood some 20 years ago. In an effort to not recreate the past, now is the time for telehealth to invest in integration to ensure the seamless flow of relevant healthcare data between all trusted stakeholders within the patient’s care continuum in which telehealth EHRs will operate.
Continue the discussion about the state of telehealth and healthcare data integration with Beau Benson, Vice President of Business Development for Iron Bridge Integration, during the American Telemedicine Association ATA19 Annual Conference and Expo in New Orleans from April 14, 2019 to April 16, 2019.