Trends found among projects funded by the Agency for Healthcare Research and Quality (AHRQ) point toward evidence of improvements in patient outcomes and experiences with the healthcare system by implementing teleheath systems, according to a new report from the National Resource Center.
Since 2004, AHRQ has invested more than $260 million in contracts and grants to more than 150 communities, hospitals, providers and healthcare systems in 48 states to promote access to and encourage the adoption of health IT.
The report focused on grants awarded in 10 states that are implementing telehealth -- the use of electronic information and telecommunications technologies to support clinical healthcare, health-related education, public health and health administration remotely. The states—Arkansas, California, Minnesota, Montana, New Mexico, New York, Oklahoma, Pennsylvania, Tennessee and Texas—serve primarily low-income rural areas with high rates of chronic illness.
Projects funded by the agency did experience technical challenges with telehealth equipment. For example, one project indicated that vendor-supplied home monitoring devices failed to work on a regular basis. As a result, approximately one-third of the patients who were enrolled in the study became frustrated with the devices and stopped using them.
Another key finding of the report was that guidelines for reimbursement of telehealth are necessary for sustainability. Although the Centers for Medicare & Medicaid Services and some third-party payors have created telehealth reimbursement guidelines, widespread acceptance of telehealth as a cost category for reimbursement has been slow to develop.
AHRQ-funded projects are working with regional payors to secure reimbursement for valuable telehealth services. For example, one AHRQ-funded project developed a framework for reimbursement that was generally agreed upon by regional payors. The project measured the component healthcare costs and demonstrated the cost savings of telehealth compared to traditional in-person care.
AHRQ-funded grantees said that technical support must be available “around the clock to ensure patient safety.” While large healthcare organizations have internal IT departments that provide support for telehealth systems, smaller organizations rely primarily on vendors for technical support, according to the report.
Additionally, telehealth systems should be integrated with EHR systems to promote continuity of care across clinical settings. Several AHRQ-funded projects reported that integrating their telehealth systems with EHR systems offered many critical benefits. Integration of systems allowed the projects to capture patient data using telehealth equipment and transmit that information to clinicians at the point of care.