programs and innovative payment models. Finally, a fresh look at point-of-care and site-of-service definitions is needed to mitigate current barriers.

Nina M. Antoniotti, Ph.D., M.B.A., R.N. Marshfield Clinic

Problems in telehealth are problems in health care. We should stop thinking about them as separate. Telehealth is a strategy to deliver health care services, but it is also subject to everything else that is going on in health care. Telehealth is not different than in-person care; rather, it is just that the two people are not physically in the same place. Adopting this philosophy eliminates many of the barriers in telehealth.

In terms of payment, shared savings models are probably the way to go. Then again, instead of paying for consults under a fee-for-service model or shared savings model, maybe it would be better to have payment for the infrastructure. The development of compelling evidence for value is necessary for acceptance by business leaders. In addition, we should not move ahead with assumptions about what patients want or value. Telehealth leaders also need to look more closely at existing models to learn more about who the providers of telehealth care actually are. Although telehealth presents many barriers, many innovative projects are going forward and making people healthier. Payers are adopting telehealth and the government is a participating partner.

Kamal Jethwani, M.D., M.P.H.
Partners Healthcare Center for Connected Health;
Harvard Medical School

Technology provides the opportunity to create a new model of delivery that keeps care simple, patient centered, and with a focus on overall health instead of illness. Technology will also help make care more collaborative. For example, health care providers will not just instruct patients to lose weight, but they will be able to give patients the tools and feedback needed to help them lose weight. Focus needs to move away from just demonstrating cost savings and move toward creative demonstrations of the value of investment. Similarly, newer research models are needed to collect and analyze data in order to prove the positive outcomes that result from the use of telehealth.

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