Massachusetts is in the process of passing parity legislation for private insurance coverage of telemedicine. It joins seven other states that are considering similar legislation in 2016. The legislation already exists in 31 other states and in DC. The American Telemedicine Association (AHA) is coordinating these efforts across the US. In addition to supporting public policy reforms, AHA also provides conferences, accreditation, practice guidelines and toolkits to fully integrate telemedicine into the delivery of healthcare.
So what do diabetes educators need to know at this point? According to AHA, telemedicine is defined as “the use of medical information exchanged from one site to another via electronic communications to improve patient’s clinical health status.” It is delivered through HIPAA compliant technology in either real time or to be stored for review at a later time (for example: data, images or video). It does NOT include FaceTime, Skype, telephone, fax or e-mail interactions. While it is commonly used to communicate between providers, it can also be used to interact with the patient in their home setting. This could include remote monitoring, mobile health tools or video conversations with patients. Stroke, dermatology and behavioral health are a few examples of what is now occurring in Massachusetts. With that, challenges around reimbursement, state licensure, technology platforms (speed and reliability) and measuring meaningful clinical outcomes still need to be addressed. As these are tackled, it would make sense that the care of chronic diseases such as diabetes will be considered viable through telemedicine.
As diabetes educators, I am sure we could all imagine a future where our patient interactions could be effectively offered via a video conversation or through remote monitoring of blood glucose readings. And wouldn’t it be great to receive reimbursement for these efforts! We hear now how our patients are faced with challenges around travel, language, ethnic food choices, scheduling of appointments at multiple locations and the costs associated with DSME. The future of diabetes education may use telemedicine to overcome these barriers in a manner that we are only beginning to understand. If that is the case, patient access and the impact we can make on diabetes outcomes could be quite impressive. Stay tuned for more!!