Health Care

Analysts Say Telemedicine Can Cut Costs,Boost Productivity by Reducing Doctor Visits

A n increasing number of employers are looking tooffer telemedicine—non-emergency health caretreatment accessed from a remote location, such

as the workplace, via electronic means—as an alterna-tive to time-consuming employee doctor visits, accord-ing to new analysis from Towers Watson.

The New York City-based consulting firm said in anAug. 11 statement that telemedicine, also referred to astelehealth, could potentially deliver upwards of $6 bil-lion per year in health care savings to U.S. companies.

Telemedicine can incorporate a variety of services,including two-way video; e-mail; mobile applicationsfor smart phones; and self-service kiosks, where em-ployees can request appointments or labs results, havea short consultation with a nurse or physician, or re-view information on a current condition and treatmentoptions.

According to Towers Watson’s ‘‘2014 Health CareChanges Ahead Survey’’ of U.S. employers with at least1,000 employees, some 22 percent of employers cur-rently offer a telemedicine option, with that numberprojected to rise to 37 percent next year. Another 34percent are considering telemedicine for 2016 or 2017.

Jonathan Linkous, CEO of the American Telemedi-cine Association, told Bloomberg BNA Aug. 15 that ifemployers use telemedicine the right way, not only willthey reduce health care costs, they can also reducetime-off taken for medical visits.

Benefits attorney Kirk J. Nahra, a partner at WileyRein LLP in Washington, D.C., cautioned that there arestill lingering questions about telemedicine in terms ofhow the medical consultations are billed to insurers, po-tential for fraud and the sophistication of the care of-fered.

‘‘This strikes me as the kind of thing that in the longrun will be beneficial to both employees and employersif it saves time and money,’’ he told Bloomberg BNAAug. 21, ‘‘so it’s probably a good thing, but it’s not un-ambiguously a good thing.’’

Reduced Absenteeism at Publisher. Carl Cudworth, di-rector of benefits at Boston-based Houghton MifflinHarcourt, told Bloomberg BNA Aug. 20 that althoughthe textbook publisher has only offered a telemedicine

benefit for about six months, he believes it already hashelped reduce lost productivity by about a half-a-day ofwork per employee based on employees opting for a re-mote medical consultation over an in-office doctor visit.

‘‘Anecdotally, I would say we are seeing fewer peopletake time off from work to go to the doctor,’’ he said.

The publisher decided to offer telemedicine in partfor the cost savings, although that wasn’t the primarydriver, Cudworth said. ‘‘The other side is convenience,’’he said.

With telemedicine, Cudworth said, employees ‘‘canget pretty routine stuff knocked out with a phone call,an e-mail or with video-conferencing from their office,a conference room or their own mobile phones.’’ Hesaid the company also is considering adding the moreadvanced kiosk technology.

Telemedicine kiosks are typically outfitted with touchscreens, integrated medical devices and video-conferencing capabilities. They enable medical provid-ers to see and treat patients in a variety of nontradi-tional health care settings, like universities, offices orretail locations. Some stations are also supported by anon-site accredited medical assistant.

Benefits attorney Kirk J. Nahra said that employers

need to be aware that when workers start

transmitting health care information through any

of these telemedicine mechanisms, there is always

a security and privacy risk.

‘‘The kiosks are something I’m really thinkingabout,’’ Cudworth said. ‘‘We’ve got distribution centersin almost every state that are often in rural areas, so ifwe can get something low-cost that would allow em-ployees to take their own vitals with technology andthen share that with a provider, that would be a greatadd-on to this benefit.’’

Privacy Considerations. Nahra said that employersneed to be aware that when workers start transmittinghealth care information through any of these telemedi-cine mechanisms, there is always a security and privacyrisk.

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COPYRIGHT � 2014 BY THE BUREAU OF NATIONAL AFFAIRS, INC. ISSN 1095-6239

Human ResourcesReport™

The privacy distinction for employers lies with em-ployees being in the office and having medical consul-tations done over the employer-provided internet con-nection, Nahra explained. ‘‘Anytime the employer isadding to the amount of sensitive information it has onits employees,’’ he said, it has to be careful about whatit’s doing with that information, ‘‘both on the securityand privacy end.’’

Nahra said employers should think carefully aboutwhere employees conduct telemedicine consultationsand offer them the best options for privacy.

‘‘Companies want to think through how they designthe process,’’ he said. ‘‘I think it would be appropriatefor an employer that was instituting telemedicine to say,‘while you’re permitted to sit in your office and havethis consultation, if you choose to do that be aware thatthe call may be monitored consistent with our [internet]monitoring policy.’ ’’ Nahra added, ‘‘That’s a fair thingto say to people.’’

Will Employees Embrace Telemedicine? ‘‘Telemedicinebecomes more attractive as lifestyles change,’’ JeffLevin-Scherz, national co-leader of the health manage-ment practice at Towers Watson, told Bloomberg BNAAug. 12. ‘‘It’s not just about dollars that can be saved,it’s about access in a way that patients actually like.’’

Still, Towers Watson noted that among the employersthat currently offer telemedicine, utilization is low, atless than 10 percent.

Levin-Scherz said that employers can boost utiliza-tion by communicating to employees the benefits oftelemedicine. ‘‘Employees need to know that this ser-vice is available, and they need to know that it comeswith certainty about what the out-of-pocket costs willbe,’’ he said.

Jeff Marks, CEO and founder of HealthPERX, ahealth benefits company that features telemedicine asits core benefit, told Bloomberg BNA Aug. 20 that tele-medicine is popular with employees. He added that be-cause the health care industry is going through majorchanges, the way people received care in the past willnot be the way they receive care in the future.

With a video consult, he said, employees ‘‘can have amedical issue resolved over the phone, talk to a doctorwithin about 20 minutes and have prescriptions sent totheir local pharmacy so they don’t have to leave work,their home or ruin a vacation or business trip becauseof an illness,’’ Marks said.

State Laws, AMA Principles. Currently, 19 states haveenacted laws regulating telemedicine issuers—insurance companies, health maintenance organiza-tions or other medical service providers. Some laws, forexample, include provisions that restrict insurers fromrequiring plan participants to have face-to-face contactwith health care providers or deny claims for servicesappropriately provided through telemedicine.

The American Medical Association’s Council onMedical Service, meanwhile, recommends a set of prin-ciples to ensure the appropriate coverage of and pay-ment for telemedicine services:

s Physicians and other health practitioners deliver-ing telemedicine services must be licensed in the statewhere the patient receives services, or be providingthese services as otherwise authorized by that state’smedical board.

s Physician must have had previous face-to-faceprofessional contact with the patient, whether the cur-rent consultation service is rendered by telephone, fax,e-mail or other forms of communication.

s Patients seeking care delivered via telemedicinemust have a choice of provider, as required for all medi-cal services.

s Patients receiving telemedicine services must haveaccess to the licensure and board certification qualifica-tions of the health care practitioners who are providingthe care in advance of their visit.

BY CARYN FREEMAN

To contact the reporter on this story: Caryn Freemanin Washington at cfreeman@bna.com

To contact the editor responsible for this story:Simon Nadel at snadel@bna.com

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