Government needs to support 'e-medicine' to improve medical care

The failure to commit money and imagination to "e-medicine" has undercut the potential of using electronic technology to deliver health-care services to the elderly and poor, a University of Illinois law researcher says.

"We have the technology; what is needed is government financial commitment," Kristen R. Jakobsen writes in the upcoming issue of the Elder Law Journal, a publication of the UI College of Law.

E-medicine (often called telemedicine) can cut as much as two-thirds of the cost of on-site care by using e-mail, faxes and telephone consultations to link patients with health-care providers. Equally important, e-medicine promises to improve access to health-delivery services in rural areas with chronic shortages of doctors and hospitals, writes Jakobsen, a graduate of the law college.

Licensing, patient consent and other issues will have to be resolved before telemedicine becomes an accepted method of delivery, according to Jakobsen. But an even greater hurdle is the federal Medicare system, which has so far resisted efforts to broaden reimbursements to include many telemedicine procedures.

"Because many elderly rely on Medicare to pay for their health-care expenses," Jakobsen wrote, "telemedicine will not provide a solution until [Congress and Medicare administrators] promulgate a suitable reimbursement scheme for this type of health-care delivery."

The Health Care Financing Administration, which runs Medicare, will not reimburse doctors who share lab results by means of fax or the Internet nor pay for phone or e-mail consultations between a doctor and patient. Instead, only "face-to-face consultations" are reimbursed, which has the effect of encouraging the most expensive type of e-medicine technology interactive two-way video conferencing.

Such interactive video requires special T1 lines that are not only costly but exist mainly in urban areas. By contrast, faxes and e-mail can deliver images and information

Contact: Mark Reutter, Business & Law Editor
University of Illinois at Urbana-Champaign

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