Dale C. Van Demark

Recent reports suggest the telemedicine industry will grow rapidly and broadly in the next few years. Patient surveys seem to lend support to these suggestions as the surveys suggest that around the world people are ready and able to adopt more telemedicine solutions

At the same time, there is a great deal of uncertainty here in the United States about the future. With the Supreme Court upholding the constitutionality of the Affordable Care Act, eyes are now turned to the many reforms that appear in the ACA - accountable care and payment reform; health insurance exchanges; the individual mandate and so on. At the same time, just as it is being asked to incur more costs through mandated technology upgrades and increased fraud and abuse enforcement, the health care industry has been rocked by the combination punch of the credit crisis and sustained economic stagnation.

In addition to the economic and financial barriers to telemedicine adoption, there is the legal and regulatory uncertainty that surrounds telemedicine. Who needs to be licensed? What can get reimbursed? Are there security or privacy issues?

Is there enough money, attention or certainty in healthcare for telemedicine solutions to really take off?

While telemedicine faces many challenges, there are a number of reasons to be optimistic. Here are three:

First, it is going on. There is no better proof that something can be done than the thing being done. Read my twitter feed - or any of hundreds of others - and you will see reports on telemedicine projects all around the country and world proving the ability of telemedicine to improve care, reduce costs and increase access - achieving the triple aims of the ACA.

Second, a lot of telemedicine projects originate outside of the conservative, deliberative healthcare industry. This is not a criticism of the healthcare industry, but rather an appreciation for the differences in the values that guide different industries. Many telemedicine products, particularly mHealth products, emanate from the entrepreneur and technology communities - communities that thrive on speed and consumerism.

While this presents challenges and risks it also represents tremendous strength - the strength to give consumers what they want, as opposed to developing something consumers need and waiting for them to arrive.

Finally, telemedicine is being funded from a variety of sources. Hospitals, health systems, doctors and insurance companies are all experimenting with telemedicine and developing approaches to achieve the needs of their particular circumstances. Entrepreneurs are bringing private investment (frequently high risk/high reward funding) to telemedicine efforts. And the government is funding projects as well, including through Medicaid programs, the VA and specialty development programs, such as the rural development program funded by the USDA.

Funding variety means that the loss or reduction of a single source will not mean the end to funding.

In addition, and perhaps more importantly, funding variety demonstrates broad interest.

And this may be the unifying principle.

Perhaps the most compelling reason telemedicine will continue to develop and thrive is that its appeal, benefits and logic are clear and broadly recognized.

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