Tom Foley
Chief Growth Officer, GenieMD, Inc.
The global telehealth and telemedicine market is expected to grow at a CAGR of 37.7% during the forecast period, to reach USD 191.7 billion by 2025 from an estimated USD 38.7 billion in 2020. Growth in the telehealth and telemedicine market is mainly driven by factors such as the rising population, the need to expand healthcare access, the growing prevalence of chronic diseases and conditions, a shortage of phyicians, advancements in telecommunications, government support, increasing awareness, and increasing technology adoption.1
As we raise awareness of Telehealth it’s a great opportunity to define it. Contrary to popular belief telehealth is not just about having a video-based engagement between the Provider and Patient. It’s certainly a component but it’s not “it”. The following four elements are core essential elements of a unified Virtual Care Collaboration Platform:
· Telehealth: The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) defines telehealth as the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, and public health and health administration. Technologies include videoconferencing, the internet, store- and-forward imaging, streaming media, and landline and wireless communications.2
· Remote Patient Monitoring (RPM): Remote patient monitoring is a technology to enable monitoring of patients outside of conventional clinical settings, such as in the home or in a remote area, which may increase access to care and decrease healthcare delivery costs. RPM involves the collection and analysis of patient physiologic data that are used to develop and manage a treatment plan related to a chronic and/or acute health illness or condition.3
· Chronic Care Management (CCM): Chronic care management is care coordination services done outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. These services are typically non-face-to-face and allows eligible practitioners to bill for at least 20 minutes or more of care coordination services per month.4
· Remote Therapeutics Monitoring (RTM): If finalized, will provide coverage for monitoring of certain data points that are outside the scope of RPM such as pain and medication adherence. While the RPM codes relate to physiologic data, CMS specifies in the Proposed Rule that the RTM codes are intended to cover monitoring of “non-physiologic data.” CMS does not specifically define “non-physiologic data,” but notes that RTM should be used to monitor health conditions through data related to, for example, musculoskeletal system status, respiratory system status, “therapy (medication) adherence,” and “therapy (medication) response.”5
The rich feature set required to bring these four elements together makes up the true essence of Telehealth, inclusive of medical device and EHR integration, coupled with simplicity and frictionless engagement models. When evaluating a Telehealth platform please ensure these elements are part of the equations.
1 Markets and Markets, Telehealth Market, Global Forecast to 2025.
2 Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), https://www.hhs.gov/hipaa/for-professionals/faq/3015/what-is-telehealth/index.html
3 Foley & Lardner, 2021 Medicare Remote Patient Monitoring FAQs CMS Issues Final Rule, December 7, 2020
4 Centers for Medicare and Medicaid, https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/ccm/hcpresources, Health Care Professional Resources
5 New RTP CPT codes introduced in Proposed 2022 Medicare Physician Fee Schedule