title: Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers.
abstract: 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 proliferation 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.
authors.affiliation: Department of Pathology, College of Medicine-Tucson, Tucson, Ariz; Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz; College of Medicine-Phoenix, Phoenix, Ariz. Electronic address: rweinstein@telemedicine.arizona.edu.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Weinstein
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz; College of Medicine-Phoenix, Phoenix, Ariz; Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, Ariz.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Lopez
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz; Department of Surgery, University of Arizona College of Medicine-Tucson, Tucson, Ariz.
authors.forename: Bellal A
authors.initials: BA
authors.lastname: Joseph
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz.
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Erps
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz.
authors.forename: Michael
authors.initials: M
authors.lastname: Holcomb
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz; College of Medicine-Phoenix, Phoenix, Ariz.
authors.forename: Gail P
authors.initials: GP
authors.lastname: Barker
authors.affiliation: Arizona Telemedicine Program, College of Medicine-Tucson, Tucson, Ariz; Department of Medical Imaging, University of Arizona College of Medicine-Tucson, Tucson, Ariz.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
mesh_terms: D040421:Cell Phone; D003406:Credentialing; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D006761:Hospitals / Q000592:standards; D006801:Humans; D007348:Insurance, Health; D008007:Licensure, Medical; D058991:Patient Protection and Affordable Care Act; D012051:Reimbursement Mechanisms; D017216:Telemedicine / Q000191:economics; D014481:United States; D014741:Video Recording
keywords: Credentialing; Disruptive innovation; ECHO programs; Licensure; Mobile health; Reimbursement; Rural medicine; Telehealth; Telemedicine; Telestroke; mHealth