Telemedicine - 2010 & 2011 - Part 1 Public Policy

Here is the first of three pieces on where we have been in 2010 and where we are going next year for telemedicine. My comments throughout reflect the gobalization of the field. The focus here is on two critical public policy issues that have received worldwide attention: healthcare and broadband:

1. Since 2004, healthcare spending has been the single largest part of the national government’s budget in the U.S. as well as most industrialized countries. Thus, reform efforts attracted huge attention throughout the world. For telemedicine, 2010 appears to have been a watershed year - the point when many in charge of government healthcare programs finally started to seriously consider the benefits of such technology. Speeches in 2010 by the head of Medicare in the U.S. and Ministers of Health in Australia, China, England and Russia all included serious declarations on the importance of telemedicine. Its role in reducing hospital readmissions and the costs of chronic care have been highlighted as well as its ability to improve services for remote areas and even for special circumstances such as postoperative care. But the gulf between pronouncements and action is still there, with spending on telemedicine and integration of telemedicine into health systems in its infancy.
   
   2011 will be the critical year when we find out whether leaders in Washington and other world capitols will follow-through with specific actions. Despite the positive press, telemedicine has been caught between lingering fears over the costs of medical technology and the enormous attention directed to electronic records. For next year, the most important factors affecting the deployment of remote health services will be an increased emphasis on both provider and regional decision making, continued outcomes from comparative effectiveness studies and practice guidelines. The outlook is brighter than ever but still not certain.



2. Plans to aggressively expand broadband access were unveiled by several countries in 2010. In the United States, the Federal Communications Commission announced in September its National Broadband Plan: Connecting America (http://www.broadband.gov/). The plan includes federal policies, financial incentives and other activities to “ensure every American has “access to broadband capability.” In December, 2010 China announced that its next Five Year Plan would include a nationwide broadband backbone for the exclusive use of healthcare. Also in 2010, Australia started to roll out its National Broadband Network and broadband policy was a major issue in that country’s national elections.
   
   We will wait and see in 2011 what effect how the governments’ plans will actually have on accelerating broadband deployment. Our attention will be on 1) how much and where government dollars will be spent to support broadband deployment and 2) how much of the available broadband infrastructure will really be used for healthcare.