With today being tax day in the U.S., many of us are focused on what we have paid in taxes, and what we get for our contributions. As our budget balloons to levels that some in both the White House and the Congressional Budget Office call unsustainable, many are thinking about how the country can lower healthcare costs (and therefore lower our collective tax burden). The question is how do we work to control the expansion of the U.S. budget while keeping a high level of care for patients? One answer is telemedicine.

Telemedicine offers a way for patients to use today’s technology to communicate with their doctors. Existing telemedicine communication tools include simple interfaces like phone, e-mail and fax. Newer tools include self-service healthcare websites and live video conferencing such as Skype or Google Wave. Telemedicine also includes home health, web-based medical decision support to self-diagnose, online PDR (physician desk reference), and direct interaction with remote medical resources via electronic collaboration tools. Armed with this technology and better information, patients take a more active role in their health. Care effectively shifts from a passive to a more proactive healthcare model.

Don’t forget that telemedicine isn’t about the technology, however. Technology is the enabling tool that allows patients to play a more active part in their healthcare. Telemedicine moves some patient care from traditional settings such as hospitals and clinics to that of the patient’s own home or location, saving us time and trips to the doctor. Today we are already using telemedicine tools such as phone, fax and email. But new more interactive self-service tools are being created all the time to help patients communicate with their healthcare providers easily and quickly, making us better informed and more in charge of our healthcare. Doctors use telemedicine to have access to the latest medical information available, and use aggregated data and baselines of care from a large collective of patients with the same health issue. This gives our doctors better information so they can provide us with the best care plans.

As access to telemedicine tools becomes more ubiquitous, patients will be able to communicate with their doctors on their iPhones, for example, no matter where either party may be located. In essence, telemedicine represents a patient revolution. It is on the path to becoming the leading way patients communicate with their doctors and doctors communicate with other healthcare providers to provide us with better care. Telemedicine holds promise for producing huge time and cost savings and improving care and outcome for patients. We can all benefit in the adoption of telemedicine, by the reduction in costs (which should help control the overall healthcare budget).

While telemedicine helps make patient care more convenient, effective and inexpensive, it cannot cure how we feel about paying taxes, unfortunately. But we can take solace in the fact that as telemedicine is adopted and becomes more common, it will help reduce healthcare costs, which should help reduce taxes for everyone.

Florida joins the rest of the nation in dealing with an epidemic of abuse of prescription narcotics and other controlled substances.  The issue is that although the abuse is illegal, these drugs are being acquired through legal means, unfortunately (written prescriptions are legal – dishonest people are providing them to others illegally).  Many stories exist that give examples of how ‘pill mills’ are nothing more than legalized drug dealing, and the widespread abuse of these drugs can devastate individual families and the community as a whole.  Though long overdue, recent legislation in Florida attempts to crack down on pill mills.  But there is the issue of lack of funding and enforcement.

The ‘fix’ to stop people from getting their ‘fix’
So, how can Florida and other states fight the pill mills for a small cost with a big benefit? It’s simple.  The state can require all controlled substances to be issued only via electronic prescription (e-Rx) through the SureScripts network, even for transactions not requiring insurance benefit checks.  When honest doctors and pharmacists have the ability to see and check controlled substance scripts against other scripts, abuse can be identified and reported immediately.  Plus these doctors and pharmacists have the added benefit of quickly checking drug interactions and drug allergy checks for their patients’ safety.

The state benefits too, because once e-prescriptions are mandated, Florida can partner with SureScripts to provide the overall patient-narcotic database that it currently does not have the funding to build.

Issues
There are some roadblocks that must be resolved, but they are worth a discussion.  First, this will not happen without cost.  Providers will have to purchase an e-prescribe software solution, but incentives already exist from the federal government to help offset those costs.   And second, the rule to allow electronic prescription of controlled substances must be adopted, which should happen soon.  If you can believe it, until now, paper-based controls and processes were considered more secure than electronic means.

More than ‘just say no’
There are huge benefits to e-prescriptions.  Most importantly, legitimate providers will give better, safer care to their patients.  And fewer illegal prescriptions are a good thing for any community.  First things first, however.  Support and momentum need to build for controlled substances to be transmitted securely via e-prescribe.  I have lots of reasons to support e-prescribing in my business, but in this instance, public health and safety is the most important one.  For me, e-prescribing has been a long time coming, and I fully support this initiative — kill the pill mills and have a few side benefits to boot.