While there may be considerable variation in telemedicine policies and reimbursement models from state to state, standards in some specialized types of telemedicine should be consistent, according to new practice guidelines from the American Telemedicine Association.
The ATA released guidelines based on clinical and empirical research that outline educational basics and operational references for two specialties: stroke and child and adolescent mental health. Developed by a working group of experts and industry leaders, the guidelines feature reviews and comments from telemedicine practitioners, health systems, provider groups, healthcare companies, medical boards and government agencies.
Both stroke treatment and mental health services seen significant impact from telemedicine, but the ATA expressed concern that some programs may be implemented faster than the evidence supporting their use is gathered. To ensure programs stay in line with emerging scientific evidence, a working group of subject experts and industry leaders, created the guidelines, which also feature reviews and comments from telemedicine practitioners, health systems, provider groups, healthcare companies, medical boards and government agencies.
“The new guidelines advance the science of and growing need for telemedicine and help ensure uniform and effective quality of services for patients in need of these health-enhancing, life-saving services,” ATA’s CEO Jonathan Linkous said in a statement.
The guidelines for telestroke treatment provide standardized parameters for assessment, diagnosis and remote consultation support for what the ATA called an “all-too-commonly employed” use of telemedicine.
“Telestroke programs frequently have similar goals including improved patient outcomes, cost savings, and the leveraging of resources, but the structure of each program may vary depending upon the organizational goals, types of available technical and human resources and types and sizes of acute care facilities receiving clinical service,” the authors write.
To mitigate that ATA’s standards lay out the best administrative, clinical and technical guidelines for telestroke treatment, which could be especially useful as more people experience a stroke than there are specialized treatment centers to care for them. Therefore, telemedicine could especially benefit underserved, rural or low-income populations.
“The telestroke guidelines are the culmination of best evidence, clinical experience, and consensus amongst many experts,” Dr. Bart M. Demaerschalk, who directs the telemedicine care division at the Mayo Clinic said in a statement.
Similar factors apply in regards to the prevalence of disease and lack of treatment options for mental health in children and adolesecents, the ATA writes.
“Increasing access to mental health services for young people is often the rationale for the implementation of telemental health programs,” the guidelines state, pointing out that it has a high adoption rate and also leads to better health overall for families. “Telemental health is an especially good fit with youth due to their frequent use and proficiency with technology. Technological literacy is dramatically improving across patients, families and providers and adolescents’ literacy increases families’ overall literacy.”
Additionally, there are few youth-trained providers to deliver care in these areas. To achieve greater parity across urban and rural – and economic – divides, the ATA wrote the child and adolescent mental health guidelines to provide clinical information for delivery of those services by a licensed health care provider.
“As the growing need for child- and adolescent-trained behavioral health providers will not be met in the foreseeable future, telemental health offers an effective way to increase access and improve quality of behavioral/mental healthcare,” Dr. Kathleen Myers, professor of psychiatry at the University of Washington and director of telemental health at Seattle Children’s Hospital said in a statement.
But as it stands, not everyone can enjoy telemedicine for mental health services even if they want them, organization points out. The FCC 2015 Broadband Progress Report showed inconsistency across the county in keeping pace with the advanced, high-quality voice, data graphics and video services available through telemedicine platforms. With the guidelines, they hope to normalize the practice to the effect that it drives technological improvements across the United States.
“This is incredibly important for children, as we strive to intervene early and maximize outcomes across the child’s emotional, social, physical, and academic needs,” Dr. Eve-Lynn Nelson, director of the telemedicine program at the University of Kansas School of Medicine said in a statement. “Supported by a growing evidence-base, the child and adolescent telemental health guidelines provide a roadmap to best practices across behavioral health specialties and youth systems of care. We hope that the practice guidelines advance these programs as an important part of mainstream healthcare for children and families.”
