Opinion: Telehealth is no substitute for the human touch

By Elisabeth Arenales

The term “long-distance” is a fading memory in the age of laptops, smart phones and the Internet. Colleagues, friends and family can stay in constant communication via Skype, text, social media, email and even good, old-fashion phone service, blurring geographic boundaries for those with access to such technologies.

Amid this revolution, the concept of telehealth is emerging as a popular option for patients who reside in rural areas where specialty care is scarce or nonexistent (and where follow-up primary care can be downright inconvenient).

Elisabeth Arenales

Elisabeth Arenales

But telehealth also makes sense in more populated communities where an on-site visit isn’t always practical or even necessary. In fact, if done right, telehealth could potentially improve the quality and reduce the costs of health care when patients don’t need to be seen in-person.

House Bill 1029, which is being considered by Colorado’s General Assembly, aspires to remove population and geographic restrictions from current laws regarding telehealth. HB1029, which defines telehealth as direct simultaneous communication (for instance, what is available through Skype), has received bipartisan support.

The bill sets some requirements for telehealth. For example, as currently written, practitioners who use telehealth get paid the same as those who see patients on site – one safeguard against using telehealth to boost the bottom line over the health of patients. But in other areas, such as ensuring that health insurers offer consumers adequate providers they can see in person, HB 1029 may not go far enough.

Though the Colorado Center on Law and Policy supports telehealth in concept, we want to ensure that a patient’s ability to see medical practitioners in person, when necessary, is not restricted. A recent amendment to the bill, added in the House of Representatives, may solve this problem.

In the end, telehealth should represent a win for consumers, not just for those potentially looking to cut costs.

Admittedly, this is a delicate balance for policymakers to strike, since, at times, patients may want, but not need, an in person consultation. But given the broad continuum of Colorado patients and their widely diverse needs, its critical to preserve the option of in-person health care.

Though telehealth will certainly play an important role in the future of health care, it should be considered an “add-on” rather than a substitute for in-person treatment. With HB 1029, Colorado has an opportunity to leverage telehealth as a way of improving health care – giving consumers more convenient  and better options  while improving actual health. In the end, telehealth might save money too – by avoiding ER visits, insuring that patients can be monitored closely when necessary, and by offering care that simply is not available in some areas, for instance by improving access to mental health care and other specialists in rural areas.

While the emergence of telehealth is a positive development, it must never compromise the overall safety and quality of health care.

One cautionary tale: In Texas, the state’s liberal telehealth policies have drawn the ire of the state’s medical authorities. One Dallas-based company, Teladoc, has been entangled in a series of legal battles for relying on remote communications in prescribing medication. For its part, Teladoc has sued the Texas Medical Board over its restrictions.

We hope that as HB1029 moves forward, lawmakers will ensure that Colorado takes advantage of the opportunities offered by advancing technology but remains mindful of the potential consequences of allowing anyone other than doctors and patients to decide when technology is a useful and appropriate substitute for in person care.

While technology has the potential to make health care better and more convenient, the human touch will always remain absolutely necessary and indispensable.

 Elisabeth Arenales is the director of the Colorado Center on Law and Policy’s Health Care Program.


Opinions expressed in Health News Colorado represent the views of the individual authors.

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