The Challenges of Telemedicine in Urology

Our digital world is moving at an incredibly fast-paced, often leaping past the guidelines and laws that we have set in place. When it comes to the topic of telemedicine, the concept of “supply and demand” has been overturned as patients and medical professionals push this practice forward. Telemedicine is a way to connect doctors and patients remotely using electronic and telecommunication technologies. Beyond remote clinical encounters, technology has permeated the health sphere with patient reminders, communication portals, clinician contact, education, monitoring, remote admissions, and interventions. Patients may be more willing to adopt telemedicine in recent years, but there are hurdles to overcome in urology.

·         The Battle

Several factors are creating problems for both patients and urologists in telemedicine. There are legal, financial, and socioeconomic factors that are not keeping up with the speed and requirements of telehealth. While it may be common knowledge that the U.S. has an aging population, what is rarely exposed is that we also have antiquated state medical laws that aren’t addressing some of the new telemedicine requirements.

·         Legal Challenges

Patients benefit from the use of telemedicine by offering services to those that are underserved, cannot travel, or do not have specialists readily available within their area. However, laws that prohibit cross-state telehealth are limiting doctors from assisting patients and they must adhere to rules that vary between states. It has become apparent that state and even federal laws need to be reviewed and updated to accommodate the medical needs of online telemedicine services.  Inpatient and outpatient consultation, television, telesurgeries, medical education, and web-based patient portals may fall under this digital umbrella. The Interstate Medical Licensure Compact that was finalized in 2017 does address physician licensing across state lines, but not all states are on board as of yet, and licensing can be a very pricey undertaking for doctors.

·         Liability Challenges

Insurance carriers have also been slow to address telemedicine. Their sluggish attitude may be due to the broad landscape of services that telehealth covers. The barriers include damage caps when a medical professional is working with patients from more than one state. The digital age has opened a Pandora’s Box and there are many questions about the future of medical malpractice when it comes to remote patient care. In urology, the patient is already vulnerable due to the barriers mentioned above, and without quick adoption of telemedicine, both the urologist and patient are facing coverage and reimbursement problems. 


 

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