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 Telehealth Industry Issues Primer on Value of Interoperable Systems

A new white paper released by the American Telemedicine Association (ATA) says the spread of telehealth will rise or fall on the ability of such systems to be interoperable throughout care settings. The paper also discusses the need for well-defined standards to guide industry growth and offers best practices for health systems when implementing telehealth programs.

Telehealth Interoperability: Driving Choice, Continuity, and Scale,” covers a range of issues and comes at a time health care providers, including long term and post-acute care operators, have installed telehealth options or are considering doing for their residents/patients.

Technological advances have allowed telehealth to spread, as has governmental support for expanding telehealth, and clinical reasons such as the effort to cut down on lengthy, nonemergency trips for patients or to alleviate the problem of a lack of doctors in rural locales.

“It is universally understood that telehealth is a necessary form of care delivery to address the supply-and-demand challenges that health care faces in the U.S., and to achieve the Triple Aim of improving quality of care, reducing health care costs, and enhancing population health,” the white paper said.

But, ATA said telemedicine’s future will be defined by interoperability. “In the era of value-based care, understanding data and how telehealth relates to the frontline care systems of both payers and providers is critical,” said Andrew Watson, MD, ATA president. “For telehealth to be relevant, and even to be a frontline system itself, it must be interoperable for ease of use, cost of integration, security, and patient/member identification. This important interoperability initiative governs much of the promise for the future of telemedicine.” 

The report details how many telehealth initiatives have suffered from a narrow service-line focus and lack of financial sustainability. “In many cases, telehealth clinical services and settings are fragmented and data are siloed, with low-volume telehealth services such as those for specific locations or clinical specialties standing alone rather than being designed as part of a larger, integrated system,” the white paper said.

Fragmented systems result in “costly, redundant software infrastructure and endpoints that limit the potential to improve overall quality and access to care,” the report said. Fragmented systems also make it hard for payers (government agencies, private insurers, and employers) to gain access to the comprehensive member data needed for claims and utilization management systems, and add to the challenges of performance tracking, reimbursement, and incentives.

“U.S. examples can be found in large delivery networks, such as large academic medical centers that provide services to smaller rural hospitals and clinics that may or may not have their own electronic health records (EHRs),” the white paper said. These smaller providers who feed high-risk or complex medical patients to the large hospitals would benefit from an interoperable telehealth platform that could share patient records directly in the large hospital’s system during a telehealth encounter, saving time and maintaining continuity of care, the report said.

In its framework for telehealth interoperability success, the white paper said the four key areas to address are people, governance, and payment models, followed by process issues covering workflows and policies. The third area is technology and the interface standards and platform solutions required, with the last priority being accountability tied to performance reporting and resource management.

Obtain the full report at

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