Thomas A. Daschle, former Democratic senator from South Dakota, has long been concerned about how his largely rural constituents access health care.
About eight months ago, Daschle, now a senior policy adviser at the law firm DLA Piper, shifted his focus to “telehealth” — a system in which health-care providers examine and treat patients virtually. For instance, instead of driving miles and miles to the nearest health center, a rural patient with a minor allergic reaction might use his iPad to chat by video with an available physician to discuss treatment options.
But until state and federal health-care laws evolve to address telehealth, Daschle’s vision of a national network of virtually accessible doctors is far off. Medical licenses vary by state, and some prohibit physicians from treating patients or prescribing medicine without an in-person visit. And there are no assurances that government insurance programs will reimburse patients for telehealth services under current regulations, according to the Centers for Medicare and Medicaid Services.
So Daschle, with help from former senators Trent Lott (R-Miss.) and John Breaux (D-La.), created a coalition of companies at the intersection of health and technology to push for changing regulations governing telehealth. Current members of the Alliance for Connected Care, which launched publicly last month, include Verizon, WellPoint, CVS and Walgreens, among others.
“Telehealth services are rapidly becoming a very important part of health-care delivery under the new paradigm, but we unfortunately don’t have a regulatory environment or policy environment that accommodates the new technology,” Daschle said in an interview. “It hasn’t been changed in about 15 years.”
The fiercest opposition to relaxing telehealth regulations comes from those concerned that virtual treatment will be of a lower quality than in-person visits, he said — so the alliance aims to combat such perceptions by demonstrating the systems to physicians, medical boards and legislators.
Health benefits company WellPoint, for instance, operates LiveHealth Online, a service allowing insured patients to have video conferences with available physicians, usually for a $49 fee per visit. Because of limitations in state medical licensing laws, the service is available in only 43 states. Patients in Oregon, Nebraska and Indiana, among others, cannot receive prescriptions through the service; patients in Texas and Alaska, among others, cannot use the service at all.
Telehealth is also limited by existing technology, such as the speed, quality and availability of Internet connections, Daschle said. In addition to pushing legislators to address telehealth, the alliance plans to encourage tech companies and network providers outside the group to install high-speed networks in underserved areas. “There will always be technological disparities around the country, and in many parts of rural America,” he said. “The cost of equipment, even if it is just a smartphone, is prohibitive. These are all issues that [are] also part of the dialogue.”
The alliance does not just benefit big companies. It also serves small firms such as HealthSpot, a Dublin, Ohio-based start-up that sells video kiosks to health centers. Patients sit in the kiosk, equipped with electronic medical devices such as wireless-enabled stethoscopes, and send their vital signs to physicians who are available by video conference.
“I’ve got a part-time lobbyist, outside counsel, legal counsel . . . it’s very expensive,” said Steve Cashman, chief executive of HeathSpot. “Pulling together the alliance, all of a sudden we’ve got the top retail pharmacies, a lot of very different technologies, a lot of varied health-care providers, rather than us just being one guy knocking at the statehouse.”
Verizon, which provides the network on which many telehealth services, including HealthSpot, operate, is working on its own products, too. Andy Mekelburg, vice president of federal government relations, said the company is developing software that would allow patients to send their weight, glucose level and vital signs to physicians between visits. Mekelburg said adoption so far has been slow, but an organized lobbying push could pave the way for business to pick up.
“The alliance is still new,” he said. “I don’t think we have a 100-percent agreed-upon on legislative track, which is why I’m focusing on [promoting] acceptance and understanding of what telehealth is.”