The Hurdles in Adopting Telemedicine: Top 5 Healthcare Challenges


The global pandemic that surfaced in 2020 catapulted many providers squarely into the telemedicine space, if they had not already been actively serving in that capacity before. For those integrating telemedicine into a traditional practice, there have been some inherent challenges—from technology access, to identifying user-friendly platforms (for provider and patient alike), reimbursement and insurance coverage issues, adherence to regulations, and ensuring privacy and security. But it’s essential to first address the elephant in the room—digital literacy. For many, having practiced traditionally for years, the adoption of a new set of systems that rely heavily on some amount of technical savoir faire is overwhelming. But, it’s not impossible to overcome the initial hurdles and move into modern care. 

The Rise of Telemedicine: A Reflection of Modern Healthcare Needs

The rise of telemedicine is a testament to the demand for accessible and efficient healthcare solutions. Let’s explore how telemedicine has grown to become an integral part of modern healthcare and identify the factors contributing to its continued expansion.

The Biggest Challenges that Telemedicine Faces

Throughout its history, telemedicine has faced various challenges, such as technological limitations, regulatory barriers, and resistance to adoption. However, the field has continued to progress, and its impact on the future of healthcare is expected to be significant. When we consider the obstacles that providers and patients face in embracing telemedicine, they typically fall into the following buckets.

Regulatory and Legal Issues

Telehealth faces many legal and regulatory hurdles including large variations in rules, regulations, and guidelines for practice. This variability contributes to the confusion for providers engaged in the practice of telehealth. healthcare providers should keep risk management strategies in mind and familiarize themselves with potential telehealth legal risks and implications. This will ensure best practices for patient care and avoid licensure or litigation issues. Telehealth rules and regulations vary greatly by state and are constantly emerging and evolving. This creates unclear understandings regarding standards and guidelines among healthcare organizations and groups alike. 

Building Technological Infrastructure and Enhancing Connectivity

The perceived cost of investing in telemedicine infrastructure, such as broadband internet access and equipment, as well as personnel training, can be a concern for many, especially in low-resource settings. Poor internet connection, lack of universal access to technology, and low bandwidth can hinder the implementation of telemedicine. Additionally, user-friendly telehealth hardware and software are essential for smooth adoption.

Protecting Data Security and Privacy

Telemedicine encounters are more vulnerable to privacy and security risks, and ensuring data protection is crucial for wider acceptance. Healthcare providers must ensure that their telemedicine platforms are secure and compliant with privacy laws. Most telehealth platforms are highly encrypted and in accordance with HIPAA standards and regulations, but no platform is 100% safe from hackers or data breaches. Both providers and patients should trust that the transmission of information during telehealth encounters remains private and secure. Numerous laws, including HIPAA, the Health Information Technology for Economic and Clinical Health (HITECH), and the Children’s Online Privacy Protection Act (COPPA), protect medical information for both face-to-face and telehealth encounters. These laws offer privacy, security, and integrity protection for health information that is collected by covered entities such as healthcare plans, healthcare clearinghouses, and healthcare providers who use electronic resources for the transmission of healthcare information.

Preventing Cyber Attacks

Preventing cyber attacks is crucial for the successful implementation and adoption of telemedicine. It’s important to regularly update software, including telemedicine platforms and operating systems, to minimize vulnerabilities. It’s equally important to always employ strong passwords and multi-factor authentication, train employees on cybersecurity best practices, and use encryption tools to protect sensitive data. Further, firewalls are key to block unauthorized access, and regularly backing up essential data is a must.

Integrating Telemedicine with Traditional Healthcare

Integrating telemedicine with traditional healthcare can provide numerous benefits but also comes with challenges that need to be addressed for successful implementation. One of the first things to be mindful of is ensuring seamless integration with existing systems. Telemedicine platforms should be compatible with existing electronic health record (EHR) systems and other healthcare technologies to facilitate smooth data exchange and communication between providers. Spruce Health developed an open API that enables automatic contact creation and sync with contacts/charts in other systems. It’s easy to update patient contact information and vital details in both systems, have events in other systems trigger messages that get sent through Spruce (e.g. appointment reminders, follow up messages, new patient welcome information), and more! Learn about integrating with the Spruce API.

Reimbursement Challenges

Telehealth use surged during the pandemic, ultimately making it feasible for providers to collect fair/normal payment for telehealth services. But the future of telehealth will be shaped by its effect on total health spending, federal and state regulations relating to scope of practice and reimbursement, and payer coverage and reimbursement policies. Several federal and state actions are aimed at extending telehealth coverage, payment parity, access, and provider scope of practice after the pandemic. Examples of bills in Congress include the Telehealth Expansion Act, which would permanently extend pre-deductible coverage of telehealth services for high-deductible health plans with a savings account, the Telehealth Benefit Expansion for Workers Act, which would allow employers to offer stand-alone excepted benefit telehealth plans to all employees, the Protecting Rural Telehealth Access Act, which would extend Medicare coverage and payment flexibility for certain telehealth or audio-only services, and the Telemental Health Care Access Act, which would eliminate Medicare requirement that mental and behavioral health providers see patients in-person in 6-months prior to a first virtual visit and at regular intervals thereafter.

Challenges in Telemedicine vs. Traditional Healthcare: How Do They Differ?

Telemedicine and traditional healthcare face different challenges due to their distinct methods of delivering care. While telemedicine offers several advantages, such as cost-effectiveness and increased accessibility, it also presents unique challenges related to technology, training, regulations, and patient perceptions of care quality. Here are some key differences in the challenges faced by telemedicine and traditional healthcare:

  1. Physical examination: Telemedicine relies on remote consultations, often making it necessary to adapt the physical examinations that are essential in traditional healthcare.
  2. Technology access: Telemedicine requires access to technology and a stable internet connection, which may not be available to all patients, especially in rural or underserved areas.
  3. Training: Both healthcare providers and patients may lack adequate training in using telemedicine technologies, which can hinder its effective implementation.
  4. Doctor-patient relationship: Telemedicine can affect the doctor-patient relationship, as some patients and healthcare providers may be reluctant to use remote consultations instead of face-to-face interactions.
  5. Regulations and licensure: Telemedicine faces regulatory challenges, including licensure issues, as healthcare providers may need to be licensed in multiple states to provide remote care to patients across state lines.
  6. Insurance coverage: Not all insurance providers cover telemedicine services, which can limit its accessibility for some patients.
  7. Cost-effectiveness: Telemedicine is generally considered more cost-effective than traditional healthcare, as it eliminates transportation and transfer expenses. However, the initial investment in technology and infrastructure can be a barrier for some healthcare providers.
  8. Quality of care: Some patients may perceive telemedicine as providing poorer quality of care compared to traditional healthcare, due to the differences in physical examination and face-to-face interaction.
  9. Privacy and security: Telemedicine relies on the transmission of sensitive patient information through electronic means, which can raise concerns about privacy and security breaches.
  10. Digital divide: Telemedicine has the potential to exacerbate existing healthcare disparities, as individuals with limited digital literacy or access to technology may face challenges in accessing telemedicine services.

How Can Telemedicine Providers Recognize Potential Issues?

There are essential steps and strategies that telemedicine providers can implement to recognize and mitigate potential problems before they become significant obstacles. Monitoring, analytics, training, and audits are key to maintaining the quality and safety of telemedicine services.

Implementing Monitoring and Analytics

Monitoring and analytics play a crucial role in telemedicine, as they help healthcare providers track patient progress, measure the effectiveness of interventions, and identify areas for improvement. However, implementing monitoring and analytics in telemedicine can present several challenges—from integration (discussed earlier in this article), to security and privacy, to performance measurement. Providers should establish key performance indicators (like no-shows, virtual wait times, patient sat, and even reimbursement by modality) along with data analytics tools to track and evaluate their telemedicine initiatives.

Providing Training and Education

Training and education are essential in telemedicine, as they help healthcare providers and students develop the necessary skills and knowledge to effectively use telemedicine technologies and deliver high-quality care. Medical schools and residency programs need to incorporate telemedicine training into their curricula, and providers and educators need to develop evaluation frameworks and metrics to assess the impact of telemedicine on patient care and outcomes. Healthcare clinics would also greatly benefit from training staff specifically on telehealth technology and protocols.

Conducting Data Security Audits

By conducting regular data security audits and implementing best practices, telemedicine providers can ensure that patient data is kept confidential and secure at all times, ultimately enhancing patient trust and satisfaction.  Data tracking offers an audit trail of all exchanges involving medical information, permitting the system administrator to verify who has used the system and/or accessed patient/client data. Healthcare providers can follow best practices to improve data security, including implementing encryption measures, using secure communication systems (like Spruce), and safeguarding telemedicine applications on wireless networks. Additionally, it’s essential to comply with HIPAA regulations, including methods used by third parties to ensure the protection of data and provisions for regular auditing of the data’s security in a BAA.  Fragmented patient care can also present challenges in data analytics, as data received from various sources may be unstructured and incomplete. Providers should organize important data types for their specific projects to ensure that data is meaningful for downstream analytics.

Analyzing Patient Outcomes

By analyzing patient outcomes and following best practices, telemedicine providers can improve the quality and effectiveness of their services, ultimately enhancing patient care and satisfaction. Telemedicine platforms and remote patient monitoring devices generate vast amounts of data that can be used to evaluate patient outcomes. Providers should establish protocols for data capture and analysis to ensure that the data is meaningful for downstream analytics. Patient and clinician factors can influence the success of telemedicine interventions, including demographic characteristics, technology learning curves, and clinician variability. Providers should evaluate these factors to identify which are associated with successful or failed telemedicine visits. As mentioned above, fragmented patient care can present challenges in data analytics, but remote patient monitoring (RPM) is particularly helpful in managing chronic conditions, as it provides visibility into patients’ lives outside of their scheduled appointments. With data collected over time, care team members can manage and treat chronic conditions in a way that is timely, meaningful, and realistic to the patient’s lifestyle.

Assessing Accessibility

Assessing accessibility is crucial in telemedicine to ensure that all patients, including those with disabilities, have equal access to care. From evaluating the accessibility of digital tools and apps to designing assessments that ensure that disabled learners have an equal chance to perform at their best, it’s critical to level the playing field, so to speak. 

Methods for Overcoming The Biggest Telemedicine Challenges

Focusing on actionable solutions, there are various methods and strategies to tackle the significant challenges that telemedicine faces, from regulatory hurdles to technological infrastructure and data security. The following emphasizes a comprehensive and forward-thinking approach to ensure that telemedicine continues to thrive and evolve.

Analyzing Regulatory and Legal Issues

Addressing regulatory and legal issues is essential for the successful implementation and growth of telehealth services. Providers should stay informed about the evolving regulatory landscape, work with legal experts to ensure compliance, and advocate for policies that support the safe and effective use of telemedicine.

Investing in Upgrading Technological Infrastructure

Healthcare providers should invest in reliable and user-friendly technology and offer training and support for their care team. Scalable and interoperable telemedicine solutions that can be easily integrated into existing systems will go a long way in delivering modern care to patients. 

Enabling Data Encryption

Ensuring data security and compliance with privacy regulations is crucial. Healthcare providers should adopt secure telehealth platforms, educate patients about privacy measures, and follow best practices for maintaining patient confidentiality.

Using Various Digital Channels

Providers should explain to their care team what pain points telemedicine will eliminate. They should also provide education and support to patients to maintain their knowledge and keep them up to date. When you consider a solution like Spruce Health, there are myriad options in place to connect provider and patient—from two-way SMS to video visits. Providers can meet their patients where they are and on terms that work for everyone.

Implementing Electronic Health Record Systems

Most telemedicine platforms integrate with one or more outside systems, including electronic health record systems. Some platforms have a limited set of integrations, while others, like Spruce, have both built-in native integrations with key partners as well as an open API that enables third parties to seamlessly connect to the platform.

Conducting Regular Performance Reviews

Performance reviews are an essential business protocol—whether it’s evaluation of the skillset and performance indicators of a team member or evaluating whether a solution in a technology stack is meeting expectations. Regular reviews can be a great way to remove extraneous third-party solutions that aren’t adding value and to identify gaps that could be filled by promising newer technologies.

The Role of Technology in Resolving Telemedicine Challenges

Telemedicine has become an essential tool in healthcare, especially as we continue to navigate the ongoing evolution of the COVID-19 virus. While there are still several challenges that need to be addressed to optimize the scalability of telemedicine, there has already been great progress in clearing some of the peskiest hurdles.

  1. Technology can help address regulations that can be a significant barrier to the adoption of telemedicine. The American Telemedicine Association identifies regulations as one of the “seven deadly barriers” for telemedicine, but this can be virtually eliminated with the introduction of secure and compliant telemedicine platforms.
  2. Technology can also help address the resistance to innovation borne from fear. Healthcare providers sometimes resist innovation in telemedicine because it creates competition. Individual providers may resist solutions to licensing barriers because they do not want competition from another state’s telemedicine network. This resistance is even greater with the development of nationwide networks.
  3. Finally, technology has proven to remove evidence barriers by providing better data analytics and reporting tools.

Technology can play a significant role in resolving the challenges that telemedicine faces. By providing better IT support systems, secure and compliant telemedicine platforms, user-friendly telemedicine platforms, and better data analytics and reporting tools, technology can help optimize the utilization of telemedicine.

Final Thoughts

Telemedicine is here to stay and it offers many benefits to healthcare. However, widespread use of telemedicine is still hampered by various barriers and challenges. Healthcare providers should work with stakeholders to implement the proposed solutions mentioned in this article. More research and policy change are essential to optimize telemedicine utilization, but an open mindset beginning at the top is instrumental in pushing the policy change and creating meaningful outcomes.

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