Administrative burdens and limits on reimbursement are among the obstacles keeping hospitals from choosing to implement telemedicine programs, according to a study by researchers from Mayo Clinic, C3O Medical Group, and UCLA Medical Center. The report surveyed emergency and critical care telemedicine users to determine factors that motivate and barriers that impede development of a robotic telemedicine program.
The study results put out by Mayo Clinic (Rochester, Minn., USA), C30 Medical Group  (Irvine, Calif., USA) and UCLA Medical Center (Los Angeles, Calif., USA) are not surprising, says Bart Demaerschalk, M.D., a neurologist and professor of neurology, director of the Mayo Clinic Telestroke Program, and co-author of the study. He says the study revealed that the primary impediments to continued success in telemedicine include licensing restrictions, administrative burden of giving physicians privileges and credentials to engage in telemedicine, lining up malpractice insurance, and limitations in the ability for billing and reimbursements.
"Fortunately, the majority of respondents indicated that the technology itself, obtaining buy-in from health care administrators, and the culture were not barriers to telemedicine," says Demaerschalk.
According to Demaerchalk, the primary motivators for providing telemedicine include overcoming service gaps, improving quality of care, and improving adherence to guidelines of practice and patient satisfaction.
The researchers on the study applauded the Centers for Medicare & Medicaid Services for a new policy that allows credentialing by proxy which, they say, has tremendously reduced the administrative burden for credentialing providers in remote areas. They also urged the development and use of interstate and national telemedicine licenses for providers and the continued lifting of reimbursement restrictions.
"The researchers in the study encourage those government and nongovernment insurers to more liberally reimburse for telemedicine consultations the same as they would for face-to-face care - particularly for acute robotic telemedicine consultations,” says Demaerschalk.