Telehealth Legal Obstacles Delay Home Healthcare

Doctor Robot

DOCTOR ROBOT: Technology like this RP-VITA device at Mercy San Juan Hospital in Carmichael, Calif., lets doctors beam themselves to remote patient bedsides, but government rules need to catch up. (AP / Rich Pedroncelli)

Home telehealth” technology promises to be a critical component of providing quality care to the growing number of Americans who need long-term services and supports to “age in place” at home. Home telehealth and related technology can make it cheaper, easier and more comfortable for seniors to remain at home and avoid nursing facility placement.

But government regulations lag behind telehealth technology, according to this article in the National Law Journal. This is disappointing because “24-hour monitoring would allow Americans who need long-term care to ‘age in place’ at home.” 

The Journal article describes telehealth legal obstacles and reimbursement challenges, but the need and opportunity is so great that I expect home telehealth to flourish as an industry as boomers rely more heavily on Internet-based video conferencing and remote monitoring than their parents did. It will be a bumpy road, however, until regulations catch up, because the laws vary state by state.

The article also prompted an online discussion in LinkedIn where I commented:

About Partisan Politics

We “theoretically” should be able to cut healthcare costs in half or greater and still improve quality and outcomes, because at $3T/year we spend twice as much as other nations but still live sicker and die younger, according to the World Health Organization. Resistance from incumbent providers (and the politicians who support them) is natural, since they’d lose $1.5T/year in revenue. It doesn’t seem to matter that that money could go toward healthcare innovations, infrastructure improvement, public education, research, or paying down the national debt.

With the corrupting influence of special interest lobbying from a medical industrial complex that spends twice as much as the military industrial complex to protect the status quo, it sure seems that no one is looking at the big picture.

About Evolving Incentives

Market forces don’t work on medical care as in other industries, because (1) consumers rely on employer-provided insurance that functions as prepaid medical care and gives them less incentive to shop around for the best value, (2) comparison shopping is difficult when hospitals keep charges secret and won’t disclose them ahead of time, and (3) patients in an emergency don’t have the flexibility to shop.

Payers are trying to transition away from health insurance as prepaid care and toward protection against catastrophic financial loss from serious illness or injury that could otherwise bankrupt families. This, and more price transparency, will give consumers an incentive to make healthier lifestyle (and financial) decisions.

Where will the most disruptive telehealth innovation come from? It’s not clear that it will originate in America, because South Korea seems poised for more innovation. After all, it has the world’s best wireless broadband infrastructure, 95% of the population have broadband, and 73% have smartphones (97% among 18-24 year olds). But the biggest need and least resistance from inertia and overregulation may come from developing nations with relatively no infrastructure and very low doctor to patient ratios. Without broadband Internet, they have wide adoption of older cellphones, so SMS texting apps can have the most impact, and that can be huge and inspire innovation here at home.

Related Telehealth Infographic

Telehealth infographic