Canada and USA Telehealth

Why is telehealth adoption in the United States so far ahead of Canada’s?

What if you didn’t have to travel 3 hours for a specialist appointment? What if mobility issues didn’t have to prevent you from attending check-ups with your physician? Canada and the United States have been working on finding solutions to these challenges for chronic and acute patients.

Providing Care to Rural Areas

Approximately 1 in 5 Americans live in rural areas, that adds up to around 59 million people. In many cases, living outside larger cities means you may not be receiving the same level of care that those in more populous areas get. This could be for numerous reasons. The quality of care being provided can be compromised when rural areas do not have access to the same specialists that a larger hospital has. Many patients are not able to drive to an urban area to see a particular specialist or physician leaving these patients with limited options.

Canada also has a large rural population – an estimated 18.7% of Canadians live in rural areas. In order to avoid patients living in rural areas or dealing with mobility issues having to travel to larger cities for proper care, the United States and Canada are exploring their options using telehealth. Telehealth is defined as the use of equipment and digital technology to provide more effective and efficient care and education. It can be used to monitor patients remotely from their homes, diagnose conditions, provide treatment, and more. So far, patients appreciate the amount of time and money they are saving with this approach and find the technology relatively easy to use.

Regulations and Billing

Of course, with new innovative solutions, comes new challenges. The healthcare system in Canada, for example, is still in the early adoption stage. The rules here in Canada generally require that patients be in a telehealth certified facility in order to conference with their physician. This is often more convenient for the patients who could be saving hours of driving by attending a certified facility closer to their home. But what about patients with conditions that make simple tasks difficult like just leaving the house? Distance aside – when telehealth is being used for remote monitoring, patients like the aforementioned are enabled to self-manage their condition from home. This can help them update their physician and care team on their conditions without needing a face-to-face interaction.

As effective as remote monitoring is, Canadian physicians may find themselves restricted when it comes to billing. Telehealth rules vary from province to province. This means in some provinces, a physician may be able to bill for time spent monitoring their patients’ condition through telehealth. In other provinces though, there are no telehealth billing codes at all.

The situation is similar in the US, but is actually further advanced than in Canada. Their rules for delivering care via telehealth are also different – depending on what State the patient is in and what insurance coverage they have. Medicare, the federal insurance covering just under 60 million Americans, invested a total of $17.6 million towards telehealth in 2015. As of 2017, the Centers for Medicare and Medicaid Services has introduced two new billing codes for remote patient management. These new codes allow for physicians and care providers to submit billing for the time spent on collecting and interpreting data (ex. glucose or blood pressure monitoring) remotely, meaning that the care provider has the ability to be paid for the time they spend monitoring and analyzing a patient’s condition and health indicators – regardless of where the patient is.

Enabling Self-Management

More people than ever are choosing to monitor their health themselves. 29% of Americans say that they’re currently tracking their health with an app or device. America’s mobile apps and the regulations around them have helped to quickly advanced the way patients and organizations use these technologies Kaiser Permanente in Northern California for example, now have 50% of their patient appointments being done virtually. Many Americans are insured under their employer’s health insurance. Just five years ago, only 7% of employer insurance plans were covering telehealth solutions. Now, 96% of private insurance companies are treating telehealth like a typical doctor’s visit. Insurers in the States seem to be adopting new care delivery technologies very quickly, and are seeing the differences it is making.

Moving Forward

Although Canada has been slower to adapt, there are definitely signs of progress. Provinces like British Columbia have acknowledged the impact connecting the entire circle of care on one platform can have on the quality of a patient’s care. In recent years, British Columbia’s provincial medical services plan (MSP) has begun to insure some digital health services. A patient is now able to use certain software to videoconference with their physician, review their symptoms, and have physicians renew prescriptions – all covered under the MSP health insurance.

However, there are still only select provinces that cover payment to care providers for telehealth services and when they are covered, there are fairly restrictive guidelines the patient and physician must follow. With technology constantly evolving and the efficiencies being realized via digital health, it’s more important than ever to take steps to ensure we make  Canadian telehealth service delivery as (or more!) accessible as it is in the United States.

Featured image courtesy of Medill News Service

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