What's really driving telehealth?

With approximately 10 million Americans using some sort of telemedicine and the market growing like gangbusters, the driving forces are beginning to emerge, right alongside some insights into states with the highest and lowest adoption rates.

Some 42 percent of U.S. hospitals have adopted telehealth platforms, in fact, and are using the technology to treat patients.

A new report published in February's Health Affairs and conducted by researchers at the Center for Connected Health, the University of Michigan and Brigham and Women's Hospital underscored several telehealth market trends present nationwide.

For one, telehealth adoption numbers are significantly higher at hospitals located in more rural areas compared to urban areas.

[See also: The limits of telemedicine.]

Adoption also varied on a state-by-state basis, which researchers attributed to myriad of factors including state policies. Alaska hospitals reported the highest telehealth adoption at 75 percent. Arkansas (at 71 percent), South Dakota (70 percent) and Maine (69 percent) were among the top telehealth adopters. 

States lagging behind include Rhode Island with 0 percent of its hospitals fully adopting platforms and Utah at a paltry 13 percent. 

"The highest- and lowest-adopting states all had fairly small populations," wrote the University of Michigan's Julia Adler-Milstein; Joseph Kvedar, MD, director at CCH; and Brigham and Women's David W. Bates, in the report. "These facts suggest that factors beyond the number of hospitals in the state, such as state policies, affect the proportion of hospitals that offer telehealth."

Researchers also found competition to be a significant market factor. Hospitals in the least competitive markets were half as likely to move forward with telehealth adoption than hospitals in competitive markets. 

"We suspect that a key advantage of telehealth is the ability to support the delivery of more-complex care as well as more-efficient care. The former is likely of particular value to teaching hospitals that may consult on the treatment of patients with complex conditions located in areas with limited access to specialists," the researchers wrote. "The latter may be of particular value to hospitals in more competitive markets that seek technologies to help lower the cost of care delivery, such as teleradiology and eICUs.

Policies related to reimbursement were also key, researchers pointed out. More payers are now reimbursing for telehealth services, which is causing an uptick in adoption numbers.  

The authors pointed to adopting broader reimbursement policies, which "may give hospitals more latitude to choose the type of telehealth to pursue and make it more likely that any type of investment in telehealth will pay off for them."



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