1. Human Resources
Report™
VOL. 32, NO. 34 SEPTEMBER 8, 2014
Health Care
Analysts Say Telemedicine Can Cut Costs,
Boost Productivity by Reducing Doctor Visits
An increasing number of employers are looking to
offer telemedicine—non-emergency health care
treatment 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 an
Aug. 11 statement that telemedicine, also referred to as
telehealth, 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 applications
for smart phones; and self-service kiosks, where em-ployees
can request appointments or labs results, have
a short consultation with a nurse or physician, or re-view
information on a current condition and treatment
options.
According to Towers Watson’s ‘‘2014 Health Care
Changes Ahead Survey’’ of U.S. employers with at least
1,000 employees, some 22 percent of employers cur-rently
offer a telemedicine option, with that number
projected to rise to 37 percent next year. Another 34
percent are considering telemedicine for 2016 or 2017.
Jonathan Linkous, CEO of the American Telemedi-cine
Association, told Bloomberg BNA Aug. 15 that if
employers use telemedicine the right way, not only will
they reduce health care costs, they can also reduce
time-off taken for medical visits.
Benefits attorney Kirk J. Nahra, a partner at Wiley
Rein LLP in Washington, D.C., cautioned that there are
still lingering questions about telemedicine in terms of
how 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 long
run will be beneficial to both employees and employers
if it saves time and money,’’ he told Bloomberg BNA
Aug. 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 Mifflin
Harcourt, told Bloomberg BNA Aug. 20 that although
the textbook publisher has only offered a telemedicine
benefit for about six months, he believes it already has
helped reduce lost productivity by about a half-a-day of
work 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 people
take time off from work to go to the doctor,’’ he said.
The publisher decided to offer telemedicine in part
for the cost savings, although that wasn’t the primary
driver, Cudworth said. ‘‘The other side is convenience,’’
he said.
With telemedicine, Cudworth said, employees ‘‘can
get 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.’’ He
said the company also is considering adding the more
advanced kiosk technology.
Telemedicine kiosks are typically outfitted with touch
screens, 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 or
retail locations. Some stations are also supported by an
on-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 thinking
about,’’ Cudworth said. ‘‘We’ve got distribution centers
in almost every state that are often in rural areas, so if
we can get something low-cost that would allow em-ployees
to take their own vitals with technology and
then share that with a provider, that would be a great
add-on to this benefit.’’
Privacy Considerations. Nahra said that employers
need to be aware that when workers start transmitting
health care information through any of these telemedi-cine
mechanisms, there is always a security and privacy
risk.
COPYRIGHT 2014 BY THE BUREAU OF NATIONAL AFFAIRS, INC. ISSN 1095-6239

2. 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 is
adding to the amount of sensitive information it has on
its employees,’’ he said, it has to be careful about what
it’s doing with that information, ‘‘both on the security
and privacy end.’’
Nahra said employers should think carefully about
where employees conduct telemedicine consultations
and offer them the best options for privacy.
‘‘Companies want to think through how they design
the process,’’ he said. ‘‘I think it would be appropriate
for an employer that was instituting telemedicine to say,
‘while you’re permitted to sit in your office and have
this consultation, if you choose to do that be aware that
the call may be monitored consistent with our [internet]
monitoring policy.’ ’’ Nahra added, ‘‘That’s a fair thing
to say to people.’’
Will Employees Embrace Telemedicine? ‘‘Telemedicine
becomes more attractive as lifestyles change,’’ Jeff
Levin-Scherz, national co-leader of the health manage-ment
practice at Towers Watson, told Bloomberg BNA
Aug. 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 employers
that currently offer telemedicine, utilization is low, at
less than 10 percent.
Levin-Scherz said that employers can boost utiliza-tion
by communicating to employees the benefits of
telemedicine. ‘‘Employees need to know that this ser-vice
is available, and they need to know that it comes
with certainty about what the out-of-pocket costs will
be,’’ he said.
Jeff Marks, CEO and founder of HealthPERX, a
health benefits company that features telemedicine as
its 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 major
changes, the way people received care in the past will
not be the way they receive care in the future.
With a video consult, he said, employees ‘‘can have a
medical issue resolved over the phone, talk to a doctor
within about 20 minutes and have prescriptions sent to
their local pharmacy so they don’t have to leave work,
their home or ruin a vacation or business trip because
of an illness,’’ Marks said.
State Laws, AMA Principles. Currently, 19 states have
enacted laws regulating telemedicine issuers—
insurance companies, health maintenance organiza-tions
or other medical service providers. Some laws, for
example, include provisions that restrict insurers from
requiring plan participants to have face-to-face contact
with health care providers or deny claims for services
appropriately provided through telemedicine.
The American Medical Association’s Council on
Medical 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 state
where the patient receives services, or be providing
these services as otherwise authorized by that state’s
medical board.
s Physician must have had previous face-to-face
professional 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 telemedicine
must have a choice of provider, as required for all medi-cal
services.
s Patients receiving telemedicine services must have
access to the licensure and board certification qualifica-tions
of the health care practitioners who are providing
the care in advance of their visit.
BY CARYN FREEMAN
To contact the reporter on this story: Caryn Freeman
in Washington at cfreeman@bna.com
To contact the editor responsible for this story:
Simon Nadel at snadel@bna.com
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9-8-14 COPYRIGHT 2014 BY THE BUREAU OF NATIONAL AFFAIRS, INC. HRR ISSN 1095-6239