Telehealth Faces Many Challenges

Telehealth has the potential to change the delivery of healthcare but faces multiple challenges to widespread adoption, according to a report by independent market analyst Datamonitor.

The report, which explored telehealth spending in North America and Europe, predicts the home telehealth market will grow at a five-year compound annual growth rate of 56 per cent, compared to only 9.9 per cent growth in the clinical market. And Telehealth's Increasing Role in Healthcare anticipates the overall global telehealth market will exceed $US8 billion by 2012.

Datamonitor notes pressures to increase quality of care while decreasing overall healthcare costs have caused interest in the application of telehealth solutions to grow significantly. In particular, homecare telehealth, also known as remote patient monitoring (RPM), is gaining traction and has already surpassed the clinical telehealth market.

The report claims that a growing, ageing population coupled with a shortage of healthcare providers is one of the leading drivers of telehealth adoption.

"Despite the benefits of telehealth, the lack of reimbursement for telehealth continues to be the most pressing challenge to widespread adoption," says Christine Chang, healthcare technology analyst with Datamonitor and author of the study.

"With no financial incentive for healthcare providers to implement the technology, providers are likely to view telehealth as an increase in workload without a subsequent increase in pay."

Currently confined to a relatively small number of patients with a few particular conditions, Datamonitor believes in the near- to mid-term telehealth will reach greater numbers of patients and more areas of healthcare, leading to an even larger market.

In the long term, Chang says, telehealth devices will also be directly available to general consumers, further increasing the scope of the market. Successful telehealth solutions will be easily incorporated into clinical workflows and linked to other healthcare technologies like electronic health records.

Datamonitor emphasized that the telehealth market is not "one-size-fits-all". The report notes that patients and providers will likely prefer different telehealth products. It also asserts that the mismatch between available technologies and the day-to-day realities and preferences of end users needs to be addressed.

"Telehealth is an emerging market with great potential to increase the quality of care, improve the delivery of care and decrease costs," Chang says. "Today's strong customer base will continue to grow as the benefits of telehealth become more apparent. However, the work flow processes and technology need to improve before telehealth adoption becomes more widespread."

But while telehealth can overcome or diminish multiple barriers to healthcare, including geographic distances, high costs and a shortage of providers, its adoption carries its own obstacles.

"Despite the potential for telehealth, its adoption in the healthcare market continues to be measured.," the report says. "Currently, most telehealth users either have a personal interest in the technology or are patients of one of the few providers who have a financial incentive to implement telehealth. The majority of providers have no direct incentive to use telehealth; providers are typically paid by patient visits or by procedures. If a patient does not come into the office, the provider receives no reimbursement even if care is still being delivered through, for example, an e-mail. Additionally, healthcare providers are known for their resistance to change and the introduction of telehealth into their daily routines is no exception.

Telehealth solutions are not yet as easy to implement as they could be, thus requiring providers to expend extra effort that most neither want nor have the time to make. Furthermore, without established technology standards or infrastructure, providers are also hesitant to invest heavily in telehealth and without changes to licensure laws, the potential of telehealth will be restricted," the report says.

It also notes human factors will impede the pace of uptake for telehealth solutions; and technical standards, infrastructure and licensure laws will all inhibit its uptake in the short-term.

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