Telemedicine’s new-kid-on-the-block status as a healthcare service delivery mode sounds like a perfect solution for a rapidly growing number of diseases, health conditions, and patient circumstances. Without broad stakeholder acknowledgment, support, and advocacy, however, telehealth service implementation will drag on and on. Patients, physicians and their care teams, medical organizations, state and federal government regulators, and insurance companies all need to be on board; any one of these groups can derail telemedicine acceptance and implementation.
A telemedicine collaboration pilot program in Massachusetts shows how stakeholders can work together to solve a long-standing medical service delivery problem. The Massachusetts Health Policy Commission funded several telemedicine pilot programs starting in 2016. The programs currently underway include teledermatology, substance abuse disorders, high school student behavioral health care services, home-based psychiatric therapy for pediatric patients, and psychiatric and other therapy and consultation needs of older adults who are aging in place. The pilots are run by Heywood Hospital, Pediatric Physicians’ Organization of Children’s Hospital, Riverside Community Care, and Umass Memorial Medical Center in conjunction with physicians and researchers at the University of Massachusetts Medical School’s Dermatology Department, and the Partnership for Community Health.
The Massachusetts pilots are working with health management organizations, primary care providers, and community health organizations. Dr. Craig Lilly, professor of medicine, anesthesiology and surgery at UMass Medical School, and director of the eICU telemedicine program at UMass Memorial Medical Center identified three forms of telemedicine that have the best chances of success: patients receiving care from physicians with whom they already have relationships; acute problems, either emergency situations or when a generalist needs a prompt consult with a specialist; and patients in systems with electronic health records. In ten years we may wonder how healthcare and medicine could possibly have worked prior to telemedicine, but in these still early days the pioneers are blazing the paths to acceptance and success.