Research on Telemedicine and The Future of Primary Care - Mayo Center for Innovation

50 Shades of Telemedicine Grey

Post Written By Gisele Waters and Lorena Macnaughtan

Telemedicine has historically provided unique healthcare opportunities for patients, including greater convenience and increased accessibility for rural and remote locations, particularly in regards to specialist consultations. With the explosion of smart sensing devices and cloud computing, telemedicine has now become even more accessible and attractive for primary care as well. In principle, providers and insurers can benefit from telemedicine because they can maintain a good standard of care at lower costs. However, its accessibility and utility for different services varies from state to state based on law, administration and private sector bandwidth. Among others, the American Telemedicine Association released a comprehensive report in May 2015, rating each state based on select indicators. While such reports are highly relevant to telemedicine providers, their content may be less useful or comprehensible to patients seeking basic answers about telemedicine.

Given the current trends and technological advancements, where patient education and empowerment are credited for revolutionizing healthcare services, there is very limited information that is useful, usable, and meaningful for patients on telemedicine. My team and I aim to address this gap by presenting a database of a state­by­state comparisons based on five codes of interest to patients seeking medical care through telemedicine. Using qualitative content analysis as an interpretation method for text documents and other digital artifacts related to the regulation of telemedicine, we analyzed four levels of “recorded human communications” in document and digital form on telemedicine across the 50 states.

We found that there is significant variability in telemedicine regulations and policies, and this could be the consequence of the lack of maturity of this field, but also of the high fragmentation of healthcare. Moreover, policies and component themes (codes) remain provider centric and are difficult to navigate for a patient across all 5 codes of interest investigated. Differences between regulations may affect accessibility and patient usability. The development of a patient­friendly resource that clearly outlines and visually explains telemedicine policy from the patient centric point of view within each state is presented and explained. This represents an attempt to increase patient awareness and education on the opportunities and challenges of accessing telemedicine.

However, we expect that such a tool will present interest for a broader audience as well. Digital technology producers or healthcare providers may find it useful to assess what services exist and to what degree they are developed or deployed in various states. Lastly, regulators may find it a robust tool to critically assess patient centric aspects of telemedicine within and across states.