Saving Telemedicine

From the Sept. 2007 Issue

It’s supposed to be the next generation of American medicine, but, at the moment, telemedicine seems more like a bad case of the dismals. If there is any hope of reaching the promise of millions of lives made better and significantly lower costs, telemedicine needs a hero, and fast.

That hero is most likely to be the accounting industry and profession.

The situation is analogous to the late Seventies, when most of the business world looked on the personal computer as some kind of kiddie toy — good for a few games of “Frogger” or a crude birthday banner spun off the old dot-matrix printer. It was the accounting industry that then stepped up to show the real value of the desktop machine, spawning a business revolution that is still alive and well 30 years later.

The medical industry in America could use a similar revolution. Rated by nearly everyone as the best in the world, the American medical industry (nevertheless) is plagued by fundamental problems mired in the old, paper-bound way of doing things. Medical charts are, for the most part, still written in nearly illegible handwriting. As are lab requests, prescriptions and nearly everything else. There is no document management to speak of, no central depository, no use of the World Wide Web to make patient records accessible to those who need them.

Medical costs are high and are growing at a pace well beyond inflation. And there’s no end in sight. Where documented and bona fide miracles are happening in telemedicine — such as home monitoring of coronary patients, or replacing trips to the emergency room with an online intervention by a trained nurse practitioner — the miracles are rapidly cut short because no one wants to pay for them.

Here’s the bottom line: American healthcare is at the mercy of large, bureaucratic organizations that don’t want to invest in advanced technologies because they can’t see the benefits in the short term. It seems easier to live with a slow, kludgy, inefficient system than go to the expense and pain of doing it better.

If this all sounds hauntingly familiar, think back to how tax returns were completed and filed prior to the mid-1980s. Or how most businesses did their accounting in the same time frame.

It took accountants, both in-house and outside, to see the value of the personal computer and bring it into the mainstream. The result has been three decades of exceptional growth in productivity and efficiency. And now it will take a new generation of dedicated, pioneering accountants to revolutionize and overhaul American healthcare.

It starts with going paperless — pushing the benefits of paperless claims and paperless payments. It steps further with document management, archiving and data retrieval, using strict AICPA guidelines for protection of private information just as we would for tax returns. And it finishes with the audits that show the clear benefits of both administrative and clinical telemedical procedures.

All of this is admittedly somewhat new, and the direct tangible benefits to the accounting industry and profession for leading the charge are tenuous at best. But the indirect and intangible benefits are a whole other matter — longer and better lives for ourselves and our families, and lower costs for our clients in reduced medical benefits costs and better controls.

Aside from those benefits, we have the sure knowledge that for the second time in just 30 years, accountants get to push superheroes and rock stars aside to be recognized as heroes to working Americans. Not by documenting the nickels and dimes saved today, but by giving the medical industry a clear vision of what it can become and how best to get there.

It’s a mission worthy of the accounting industry and profession.

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