Q: Are there issues related to insurance coverage in telemedicine with payers being able to afford or get reimbursed for this?
A: (Shahada) Organizations like the American Telemedicine Association (ATA) have played a big part in advancing the cause and the advocacy for payment. A lot of the big payers in the United States have been supportive and encouraging with this kind of payment model. At Cisco, if we are working with a hospital in our region, we can build payment models for telemedicine directly through our own policies and procedures. An area that is also starting to advance is the government. Some states have mandated payment for telemedicine for certain diseases and code coverage—we think telemedicine is going to be a great tool for healthcare reform. It’s going to be an opportunity for us to build out new resources, capabilities, and access to care and services. This year ATA put together a formal request for CMS. In addition, last year, we worked with the FCC on their broadband plan. They urged CMS for broader health payment reform around telemedicine. So we have good instances of it, and we expect to see more and more as the ROI starts to come through.
Q: No conversation about healthcare occurs these days without discussing policy and regulations. Is there anything on the horizon in the next 6 months or so?
A: (Shahada)There is a greater interest right now with the FDA looking at the governance of these devices. Cisco has taken a very careful approach to understanding that and is working with the FDA on the appropriate approvals. I encourage everyone to take a look at the new regulations to understand how telemedicine is moving in that area. We are starting to see more and more states look at the payment models for Medicaid around telemedicine in order to increase coverage and reduce cost.
Q: What are some specifi c types of technical solutions coming to the market right now in terms of telemedicine programs?
A: (DeFranseco) You have the basic stationary care where you build out a room or a kiosk. Here a patient would come into an enclosed area and sit down and have that encounter with the physician. The area would have some medical devices to measure things like a heart rate, heart sounds, temperature, and vital sounds. You might even have some cameras for Charge-Coupled Devices (CCD) to look at dermatology- type of events. We see other technology evolving where video is the core or the driving infrastructure along with the audio and the data. Those form factors could either be stationary or mobile—on a cart for example. We also have the advent of tablet technology. It runs the gamut from handheld to full-room scenarios. Suffi ce it to say, it is leaps and bounds from where it was years ago and fi ts many different form factors.
Q: What feedback have you heard from those that have been involved with some of the Cisco technology out there?
A: (DeFranseco) Like Ash said, it has been rated in the 90th percentile for acceptance. Comments we have heard are that they like the individual one-on- one dimension. It’s not, “waiting in the waiting room for an hour, getting their 10 minutes, and moving on.” These things are scheduled for the most part, you get immediate gratifi cation, and you don’t have to wait for 3 weeks to get that specialist on call. They are very immersive, they are very friendly, and I think the patients have been very receptive to it. And the physicians and the healthcare professionals aren’t travelling. Windshield time has been decreased, and that is a big concern these days with healthcare costs.
Q: What are some other new types of virtual healthcare that you see on the horizon?
A: (DeFranseco) I think what we are seeing is this whole scaling down to home healthcare. There is tremendous pressure in the industry to deliver wellness programs and post-hospital care visits. You can reduce your transportation costs and readmissions, and deliver very high healthcare to any setting. One visit to the ER is very expensive as we all know, and if this can be a cut off before we get that far, that is good for everybody—the payers, the patients, and the attending physicians. Technology is getting there, access to a network is defi nitely much better than it has ever been, and costs have been reduced. I think we will continue to see that evolve; needs are higher than what we can deliver today. There has to be another way that we can deliver care today in an effective manner and telepresence and videoconferencing in this whole healthcare scenario is really one good way to attack that.
Q: Who is leading the charge with virtual healthcare? Are we seeing it at some of the larger hospitals as opposed to some of the smaller clinics or doctor’s offi ces?
A: (Shahada) We are seeing it in three areas. Primarily, the brand name medical centers that have a lot of referral capabilities have been adopting it. The second area is of children’s hospitals. We have seen a big uptake in children’s hospitals where they have a lot of unique programs; there are very unique sub- specialties there. Finally, the other area we are seeing is national hospital systems—the ones that cut across multiple state lines.
To learn more about Cisco Health Presence solutions, give us a call today. 1.800.395.8685
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