Sherilyn Z. Pruitt, M.P.H.
Health Resources and Services Administration
One theme that emerged over the workshop included an emphasis on the relationship between the patient and the provider; technology should not be seen as a barrier, but something that facilitates access for more patients to interact with their providers. Similarly, the focus should be on the patient and not the technology. Also, there was a lot of discussion about the consideration of the site of service being where the provider is, instead of where the patient is. Another theme was to think about a more systematic way to implement telehealth across the country, so that every person can get appropriate care no matter where they are, and what that system might look like. While many people are working on their own roles, we need to take a step back and look at the system as a whole.
Is there a way to accelerate getting knowledge into practice across the country, especially because technology changes at such a rapid pace? For example, Models That Work was a program that looked at effective community-based models. With grant funding, they were able to create replication guides (e.g., what they did, how they did it) that other communities could download off the Internet. The communities then used government funding to contract directly with the models’ designers to come help them adopt the program.
As we look forward, other questions come to mind. Why do we not appreciate the evidence on telehealth that is already available? How can we increase the number of payers who reimburse for telehealth? How can we learn from what is happening in other countries?
Thomas S. Nesbitt, M.D., M.P.H.
University of California, Davis, Health System
Questions arise when we try to think about what telehealth would look like if we did it right. What would a technology-enabled rural community look like? What would the services be? How would chronic disease and home health management work? How would it work when you go to your physician and find that you need specialty care? What would it look like when you go to the emergency department with a stroke, or you are in the intensive care unit?
We are beginning to assemble all the pieces. We heard that the evidence is very strong in some areas, but we also heard there is an opportunity to do studies using a variety of methodologies, and we do not have to be ashamed that we do not use just one methodology for looking at telehealth and its benefits. However, we need to have a better way to pull together consensus of the evidence that is more accessible to people. It is not just policy makers