Reimbursement Assignment
In a one-page, APA formatted, double-spaced paper, please discuss the following:
- What is the difference between asynchronous vs. synchronous telemedicine? What are the advantages/disadvantages?
- What insurance reimbursement obstacles are there for both synchronous and asynchronous telemedicine? What are possible solutions?
- Include at least two references.
Sample Answer
Telemedicine and Reimbursement
There are two main telemedicine models: synchronous and asynchronous. In synchronous telemedicine, there is a live, two-way communication channel between the patient and the healthcare practitioner (Khosla, 2020). It mimics face-to-face interaction, but better since it does not require the parties to be in the same physical location. Therefore, the technology facilitates the primary collection of healthcare data by the physician. Conversely, asynchronous telemedicine, also known as store-and-forward, involves the initial collection of health data by the patient or a general practitioner. The data-collecting party then remits the information to a secondary provider, usually a specialist, for analysis and diagnosis (Gregory & Llewellyn, 2018). Asynchronous telemedicine does not require the patient to be present, as the healthcare provider reviews the sent information offline at their convenience.
Advantages and Disadvantages
Synchronous telemedicine is advantageous since it allows quicker health service delivery, especially in emergencies. The patient does not have to waste time visiting a healthcare facility, thereby enhancing the chances of better clinical outcomes. Next, the technology facilitates counter-checking. The caregiver can confirm some details if they feel it is necessary. Hence, they have accurate data when diagnosing a patient. Synchronous telemedicine is also cost-effective since patients do not have to incur travel and administrative expenses before receiving health services (Khosla, 2020). However, the approach faces some drawbacks, such as requiring access to reliable and high-speed internet, which may not be readily available in remote areas. It also requires the patient to have sound knowledge on using communication and telehealth equipment.
Meanwhile, asynchronous telemedicine decouples the interaction between patients and caregivers, allowing them to participate at their convenience. Physical physician visits and synchronous telemedicine require both parties to be simultaneously available. Thus, asynchronous addresses this challenge by storing and forwarding the health data when either party is ready (Gregory & Llewellyn, 2018). Hence, it improves overall access to healthcare services. The patient-caregiver detachment also helps overcome language barriers since each party sends and receives information in the language or format that is most sensible for them. However, asynchronous telemedicine has some shortcomings, with the greatest being that it is not ideal for emergencies. There are delays on both sides, which can slow the healthcare process significantly. Also, counter-checking can be cumbersome, making it more likely for the physician to use incomplete or inaccurate data. Therefore, these disadvantages limit the extent of use of asynchronous telemedicine.
Reimbursement Obstacles and Solutions
Asynchronous Telemedicine
The main reimbursement challenge for asynchronous telemedicine is that Medicare does not cover it in most states. For instance, Alaska and Hawaii pay but only for certain health scenarios (Abbasi-Feinberg, 2020). The state-based Medicare reimbursement regulation impedes extensive reimbursement, especially where the patient and caregiver are in different states. The solution would be legislation that enables the creation of a standard reimbursement protocol across all states.
Synchronous Telemedicine
Meanwhile, the use of platforms not compliant with the Health Insurance Portability and Accountability Act (HIPAA) presents a reimbursement challenge for synchronous telemedicine. During the height of the COVID-19 pandemic, caregivers began using commercial teleconferencing platforms, including Skype and FaceTime, to attend to patients (Khosla, 2020). Such platforms lack the capacity to establish costs, making reimbursement difficult. The solution would be creating a HIPAA-compliant platform that facilitates accurate transmission of cost information to Medicare. Hence, reimbursement would be accurate and timely.
Conclusion
Despite the shortcomings and reimbursement challenges, telemedicine is the future of healthcare service delivery. Both synchronous and asynchronous models will be necessary to address different needs. Hence, healthcare stakeholders and legislators should collaborate to create effective solutions to these problems and enhance technology usage in medical practice.
