Can Telehealth Save Medicare?

By Charu Raheja, PhD

Currently Medicare is waning under the pressure of much of America’s population living longer than the system can support. With this in mind, the healthcare system is desperately in need of innovative ways to improve healthcare and reduce costs. One possible solution to the problem is the proposed Medicare Telehealth Parity Act of 2015, H.R.2948, sponsored by Rep. Mike Thompson and introduced July 7, 2015. The bill is the beginning of a revamp of Medicare’s approach to treatment and care that could improve American health and lower healthcare costs as a whole. Telehealth allows patients to contact a nurse or physician directly via their cell phone or computer to discuss symptoms and receive care without leaving the comfort of their homes.

Though telehealth as a whole includes many moving parts, one essential component for the success of telehealth is telephone nurse triage. Telephone nurse triage is a system by which registered nurses are available to take patient phone calls and determine the proper amount of care needed in the proper time frame. Nurses use standardized symptom-based protocol guidelines to ensure high quality of care with every phone call.

With convenient access to nurses 24/7, patients are empowered to make the right decisions about their health and what the next steps for their symptoms should be. Patients who better understand their conditions and have a method of self-management, such as access to a registered nurse, are more able to decipher the appropriate level of care, thus avoiding costly ER visits and improving overall patient satisfaction.

An important aspect for the successful use of nurses in telehealth is for the nurses to have direct contact with physicians. In many systems triage nurses communicate patient call information with providers, allowing for better patient relationships with their provider and continuity of care. Nurse triage facilitates the best use of the healthcare workforce by alleviating doctor workload pressure and allowing them to reach the most urgent cases first.

By utilizing telephone nurse triage as an affordable telehealth option, everyone benefits; providers can be assured that their patients are receiving the best care possible. Patients are satisfied with their care and confident in decisions made regarding symptoms they were once unsure of. And the cost of healthcare in America will be driven down by the efficiency and convenience of patient access to healthcare professionals at reduced costs.

Currently most Americans think of telehealth as an option for those living in remote areas where it may be difficult to visit a doctor’s office, but there is infinite value in the use of telemedicine in urban city centers where the emergency room census can be extremely high. Telehealth provides a positive alternative to unnecessary urgent care and emergency room visits, lowers hospital re-admissions—and with the healthcare costs saved—could in fact save Medicare.

Charu Raheja, PhD, is the CEO, chair, and co-founder of TriageLogic. Founded in 2005, TriageLogic is a URAC-accredited, physician-led provider of high-quality telephone nurse triage services, triage education, and software for telephone medicine. The TriageLogic Group serves over 7,000 physicians and covers over 10 million lives nationwide. Charu also serves on the board of Community Health Charities. For more information visit www.triagelogic.com. (This piece was inspired by Michael Hodin’s post “Saving Medicare” in Huffington Post, October 26, 2015.)

[From Connection MagazineMarch/April 2016]

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