The implementation of remote healthcare — telehealth services — reformed medicine. The infamous pandemic accelerated the growth of the already substantially expanding industry. With the skyrocketing investment in virtual care, new legal regulations that expand the possibilities of remote healthcare, the telehealth industry is predicted to expand from $3 billion to $250 billion.
Yet, many barriers are hampering telemedicine’s success. This article explores the challenges of telemedicine and examines solutions to resolve current issues.
Main Obstacles the Telemedicine is Facing Today
Not only did the pandemic accelerate the implementation of telemedicine, but remote health services became a necessity. 2020 McKinsey research reported that almost 50% of patients opted for telemedicine instead of canceled medical consultations.
Pandemic allowed those who were hesitant to try out telemedicine. Still, there are many challenges to overcome.
According to CRICO’s national CBS Database, 66% of malpractice cases in telemedicine from 2014 to 2018 were connected to misdiagnosis. Undoubtedly, misdiagnosis is a serious issue that slows down recovery and can worsen a patient’s health.
High rates of misdiagnosis affect the patients’ health and the cost of healthcare services for providers. Wrong diagnosis leads to more considerable expenses on medications and adjusting the unfit, potentially hazardous treatment.
Nevertheless, telemedicine is a part of healthcare, not immune to general issues. Misdiagnoses are not the unique drawback of remote medical inspections.
Compensation and Parity
On the legal side, telemedicine faces two main drawbacks. They revolve around the payment parity law and the coverage parity law.
Payment and coverage parity laws are the subject of both federal and state jurisdiction. The payment parity law calls for equal compensation both for in-person and remote telehealth medical services. The coverage parity law requires providers to cover telehealth.
On the one hand, the coverage parity situation has significantly improved. As for 2021, 43 states implemented service parity (which is also called coverage parity). These numbers look promising in comparison to 2019 when only around two dozen states had coverage parity.
On the other hand, for the payment parity, the situation is somewhat different. As for 2021, only 14 states have established payment parity, ensuring equal telemedicine and in-person medical consultation compensation.
The ambiguity in the legal realm makes financial investment risky and does not attract the attention of healthcare providers to telehealth.
Senior Patients and New Technology
Even in the 2021 century, when everything seems completely digitized, not everyone has access to basic technologies. Elderly citizens are one of those groups. According to the 2021 research, 25% of adults 65+ never use the internet. Moreover, there are still 7 % of U.S. citizens who do not have internet access at all.
Even those seniors, who have internet access, often have difficulties with using it. Firstly, many do not have digital skills like creating an account or using a web camera. Secondly, for those who have hearing and vision difficulties, video chatting is challenging.
The acknowledgment of these issues is vital for creating tailored solutions and special UX/UI design.
Overall, according to the healthcare providers, lack of digital skills and lack of access to the technologies are two main barriers to telehealth.
Refusal To Try Out New Technologies
Inability to try out the benefits of telehealth comes not only from the patient’s end. Firstly, many healthcare professionals do not trust technologies and medicine digitalization. Despite many surveys and reports that prove that paper documentation is ineffective in many processes, for instance, when it comes to timely payment collection, providers insist on sticking to the old ways, which do not require additional investment. Apart from the inability to use the technologies, many (both patients and professionals sides) simply prefer traditional, in-person consultation to telehealth solutions.
Secondly, even if the global pandemic left little choice but to try out remote medical services, many providers have no assets to employ telemedicine solutions. As well as some patients, many vendors do not have the required integration tools and efficient software. For instance, almost 60% of medical professionals are unable to integrate telehealth software and EHR due to low tech support.
Despite the trust issues and technical difficulties when it comes to the implementation of telehealth software, the situation is changing. Already in 2020, almost 85% of patients were prone to choosing healthcare providers who offered telehealth services.
With all-consuming personal data digitization comes an issue of data security. According to the 2021 survey, the healthcare industry has held the top position in the reported data breach since 2017.
Medical records are sources of delicate and intimate data. This, unfortunately, makes them a valuable target for cybercriminals.
The new technologies, like telemedicine and video communication, offer new possibilities for data breaches.
Thus, integration of telemedicine requires developing new security tools, encryption protocols, and data interoperability systems. It entails additional security investments for medical providers. Additional expenses, including in the security sector, are considered a significant obstacle for telehealth implementation.
Privacy Rule and Telemedicine
Medical data security conversation always includes the HIPAA Privacy Rule. Uncompromising HIPAA regulations are developed to protect one’s privacy and sensitive personal data, so the violations entail severe and expensive consequences. For instance, the maximum fine for the Privacy Rule violation is $1.5 million per year, and some misconducts are considered criminal offenses.
During the pandemic, HIPAA loosened regulations for telemedicine services by canceling penalties for some types of video and audio communication. Yet, these waivers are temporary. To ensure a secure long-term investment climate for telemedicine, a substantial part of the current legislation should be reformed.
Specific Challenges of Telemedicine
Barriers to telemedicine implementation vary by the location and party involved. Here are some examples of problems faced by the specific sectors of telemedicine.
1. Rural areas. Unfortunately, there is still a gap between medical care in big cities and rural areas. Telemedicine is not an exception. The issues of data digitization and general distrust in technology-related medicine practices are particularly topical in rural areas.
2. On-demand nursing. Particularly the certification and license are one of the main challenges for nurses in telemedicine. Often licensing is state-specific, and the lack of multistate licenses makes it impossible for nurses to provide care for patients from different states. Moreover, the necessity to learn how to use complicated software is a big barrier for nurses.
3. Patient satisfaction. We have already discussed barriers to telehealth adoption from the patient’s side. There is one more interesting juxtaposition: despite almost 75% of patients reporting a positive first telehealth experience, patients are still reluctant to change “traditional” care for telemedicine. Lack of digital literacy, complicated features, and distrust are the main factors that slow down the implementation of telemedicine.
Current Telemedicine Solutions
Overcoming the key barriers requires time, finances, and cooperation. Yet, as you can see from the article, we are moving in a positive direction. Here are the top solutions which can accelerate telemedicine integration and resolve barriers we discussed in this article.
1. Government cooperation. Cooperation between federal and state governments is crucial to ensure multistate licensing, payment parity, and expansion of telehealth services.
2. Viable software. Healthcare providers should invest in software usable both for doctors, nurses, and patients. Thus, a team of programmers must be engaged who has experience specifically in the healthcare industry and understand the intricacies of medical services on both ends.
3. Software legal compliance. Legal issues are serious barriers that occur on multiple levels of telemedicine integration. In addition to being user-friendly, software must be tailored to HIPAA regulations.
4. Staff training. Any new methodology or new equipment requires training. The same goes for telemedicine. Healthcare providers should develop engaging training for their telemedicine software. This solution can solve the problem of the inability to use new tools and lower distrust of the new digital methods. Medical professionals, who are fluent in telehealth software, have new tools to perform medical care. Also, they can ensure patients that remote consultation is as effective as in-person ones.
5. Identifying sectors. While remote healthcare offers limitless solutions, there are still many services that can only be delivered in person—identifying when it is applicable to use remote consultation and when it is necessary to come to the hospital is vital.
What Is Next?
By erasing borders between patients and medical professionals, telehealth is drastically transforming the U.S. medical system. During the pandemic, telemedicine demonstrated its benefits and proved its incredible potential. Yet, to become truly integrated, the telemedicine industry needs to identify what drags it back and implement appropriate solutions.
About Ivan Dunskiy
Ivan Dunskiy is the Founder and CEO of the software development company Demigos Healthcare. Demigos develops high-quality IT products for healthcare organizations and startups in the USA, Canada, Europe, and the UK. Ivan worked as QA, Software Engineer, Project Manager in different IT companies before founding Demigos. Having the entrepreneurial spirit, he co-founded two startups and managed delivery of more than 40 IT projects.