Our resident health care expert here in Verizon’s DC office, Andy Mekelburg, appeared on a congressional panel recently to discuss barriers to telemedicine. Below is the blog he wrote about what he shared and learned.
Imagine a doctor on a late-night shift who can’t diagnose the cause of a newborn’s erratic heartbeat. He places a call to a cardiac specialist several states away. The cardiologist is licensed to work in both states, and the doctors collaborate on the case. Over an online connection, the two share charts, X-rays, and live video of the patient. They quickly identify the need for surgery, and the baby is immediately taken to the OR. The surgery is a success, and the baby now faces a normal life expectancy, all thanks to two physically-distant doctors who were able to look each other in the face and find a solution.
This was the true story told by Dr. Craig Sabel, Director of Echocardiography and Telemedicine at Children’s Medical Hospital, as the American Telemedicine Association hosted a congressional briefing on “Physician Licensure Barriers to 21st Century Healthcare”. I also appeared on this panel, and discussed Verizon’s role as both an enabler of medical connectivity and a provider of employee health coverage. We enable health IT through our state-of-the-art networks, we’re developing a suite of digital health care products based on our 4G LTE network, and we support independent medical IT entrepreneurs at our Innovation Center in Waltham, MA. But we don’t just enable and provide health care technology, we also benefit from it as consumers. Between our active and retired employees, and their families, Verizon provides health care coverage for more than 800,000 people. We spend nearly $4 billion per year on this coverage, which is more than the health care expenditures of seven U.S. states.
We want the best care for our employees and the most efficient use of resources, and connectivity helps create both. After all, the whole point of connectivity is to escape the barriers of geography and communicate as though we’re face to face. Sometimes that’s for fun, like when we video-chat with a loved one who’s away on business. And sometimes it’s to save lives, when two doctors combine efforts across hundreds of miles to diagnose a patient and find a cure.
We also have deep experience on the demands and expectations that consumers place on connectivity. Customers want their technology to work; they want reliable, fast access to their data. They want ease of use, and to be able to access content across a variety of platforms, whether that’s a mobile phone, tablet, or desktop PC. And they rightly expect that this data will be kept secure and private. Verizon has heard this message loud and clear, which is why we’ve invested tens of billions of dollars in the super-fast, secure networks that enable online collaboration between doctors and patients. That investment is necessary to create bandwidth for services like sharing high-resolution x-rays. Next-generation connectivity enables doctors to enhance services and create new value for consumers. These networks let everyone share success: doctors help each other, hospitals reduce costs, and patients receive better care.
But the potential benefits of connectivity-enhanced care are undermined by policies that reinforce arbitrary physical borders. Current state law requires a doctor to keep a medical license for every state in which he or she may have patients. The licenses are expensive, renew on different schedules, and have not been proven to create better medical care. The application of these rules is not consistent. Specialty certifications (like for cardiology) are already granted nationally. And overnight radiology analysis is often performed outside of the US. That’s right, your X-ray could be sent to a doctor in India, but not one in Indiana. State licensure restrictions arbitrarily prevent key services from getting to the patients who need them, particularly those in rural areas who could most benefit from telehealth.
There are signs of progress, though. A staff member of Congressman Glenn Thompson (PA) appeared on the panel to discuss the Servicemembers’ Telemedicine and E-Health Portability (STEP) Act, which was signed into law in December as part of the National Defense Authorization Act. The STEP Act allows VA and military doctors to bypass the state licensure system in treatment of veterans and active-duty servicemembers. Thanks to this law, if a veteran from New Mexico is visiting California and needs to speak to a doctor, he doesn’t need to choose between going to a stranger and going home.
We care about delivering the best care to our employees, and that requires the type of connectivity-enabled collaboration that Dr. Sabel described. We also care about using technology to bend the cost curve of health care. We can make strides toward both of these goals by overcoming out-of-date obstacles and unleashing the life-saving benefits of telemedicine.