Telemedicine, Telehealth, and Mobile Health
Applications That Work: Opportunities and Barriers
There has been a spike in interest and use of telehealth, catalyzed recently by the anticipated implementation
of the Affordable Care Act, which rewards efficiency in healthcare delivery. Advances in telehealth services
are in many areas, including gap service coverage (eg, night-time radiology coverage), urgent services (eg,
telestroke services and teleburn services), mandated services (eg, the delivery of health care services to prison
inmates), and the proliferation of video-enabled multisite group chart rounds (eg, Extension for Community
Healthcare Outcomes programs). Progress has been made in confronting traditional barriers to the prolif-
eration of telehealth. Reimbursement by third-party payers has been addressed in 19 states that passed parity
legislation to guarantee payment for telehealth services. Medicare lags behind Medicaid, in some states, in
reimbursement. Interstate medical licensure rules remain problematic. Mobile health is currently undergoing
explosive growth and could be a disruptive innovation that will change the face of healthcare in the future.
Ó 2014 Elsevier Inc. All rights reserved. The American Journal of Medicine (2014) 127, 183-187