-8-professionals and patients become more comfortable with the use of the technology, and asreimbursement policies recognize and encourage the use of telemedicine:• Remote consultation and monitoring allows patients and health care practitioners tomeet virtually without the patient needing to travel.• Medical imaging applications allow digital images to be captured and transmitted toradiology, pathology, cardiology, and other specialists at disparate locations forevaluation. 19 These capabilities enable members of a medical team to formulate carebased on the best possible diagnostic tests, administered without regard to thegeographical location of the doctor-diagnostician. 20• Electronic prescription capabilities permit doctors to write and transmitprescriptions to pharmacies in digital form. 21 Digitizing prescriptions will dramaticallyreduce errors and the numbers of calls required to verify prescription details. 22• Secure messaging permits safe and robust communication among health careprofessionals as well as between professionals and their patients. 23• Implementation of improved, electronic health record keeping assures that medicalteams have a real time, comprehensive view of a patient’s medical history, permittingmore informed and accurate decision making. 24 Moreover, significant billingimprovements are also possible when electronic records are maintained; greaterautomation lowers administrative overhead and also provides for a reduction in errors. 25• Finally, remote surgery or even remote intensive care units may also become viabletreatment options in some contexts, provided the right facilities and infrastructure are inplace. 2619. Turisco & Metzger at 10.20. Id. at 10.21. Tipping Point at 22.22. Id. at 22-23.23. Id. at 28.24. Id. at 28.25. Id. at 18-20.26. Id. at 40-43; see also Neuberger at 10.
-9-B. Key Patient Groups Benefiting from TelemedicineTelemedicine capabilities hold particular promise for patients with chronic illnesses, 27who account for roughly 80 percent of increases in Medicare costs. 28By improvingcommunication between patients and health care professionals (that is, in terms of quantity ofcontacts as well as quality of information exchanged), practitioners receive more information, ata greater level of detail, from which they can base treatment decisions. 29In addition, byexpanding the presence of the medical team in a patient’s long-term care, tele- and video-visitscan improve adherence to prescribed treatment regimens. 30 More successful and closely tailoredtreatment in turn can significantly reduce morbidity, can improve quality of life, and candecrease admission to hospitals and nursing homes for more aggressive care. 31Studies demonstrate the substantial benefits of telemedicine to diabetes patients, 32whose costs of care contribute significantly to increases in Medicare expenditures. 33Telemedicine better enables health care professionals to supervise weight management plans,document activity levels, and monitor blood glucose signs—activities of particular importance to27. Audrey Kinsella, Telehealth Opportunities for Home Care Patients, 21 HOME HEALTHCARE NURSE 661,662 (2003).28. Lisa Remington, 2008 MegaTRENDS Predictions and Forecasts Across the Healthcare Delivery System,Remington Report at 9 (Jan./Feb. 2008), available at http://www.remingtonreport.com/toc.asp.29. Kinsella at 662.30. Id. at 662.31. Helen Noel, Donna Vogel, Joseph Erdos, David Cornwall & Forrest Levin, Home Telehealth ReducesHealthcare Costs, 10 TELEMED. J. E-HEALTH 170 (2004) (concluding that “integrating home telehealth with thehealthcare institution’s electronic database significantly reduces resource use and improves cognitive status,treatment compliance, and stability of chronic disease.”). See also Kathryn H. Dansky, Lisa Palmer, Dennis Shea &Kathryn H. Bowles, Cost Analysis of Telehomecare 7 TELEMED. J. E-HEALTH 225 (2001) (concluding thattelemedicine intervention reduces direct and indirect costs associated with hospitalization by as much as 62.5percent, and permits full recovery of equipment and personnel costs necessary to operationalize telehomecareservices). See also Kinsella at 662; see also Hebert et al. at 789.32. Kinsella at 662-64. See also Pennsylvania Homecare Association, Telehomecare Research Results(2004), available at http://www.pahomecare.org/teleresearchsum.pdf.33. Remington at 9.