Center for Telehealth and Cybermedicine Research, University of New Mexico Health Sciences Center: A Model of a Telehealth Program Within an Academic Medical Center

Sustaining and Expanding Telehealth: A Survey of Business Models from Selected Prominent U.S. Telehealth Centers

INTRODUCTION

Telehealth centers across the country, including our own center, are addressing sustainability and best practice business models. We undertook this survey to explore the business models being used at other established telehealth centers. In the literature on telehealth and sustainability, there is a paucity of comparative studies as to how successful telehealth centers function.

METHODS

In this study, we compared the business models of 10 successful telehealth centers. We conducted the study by interviewing key individuals at the centers, either through teleconference or telephone.

RESULTS

We found that there are five general approaches to sustaining a telehealth center: grants, telehealth network membership fees, income from providing clinical services, per encounter charges, and operating as a cost center. We also found that most centers use more than one approach.

CONCLUSION

We concluded that, although the first four approaches can contribute to the success of a center, telehealth centers are and should remain cost centers for their respective institutions.

Distributing medical expertise: the evolution and impact of telemedicine in arkansas

Arkansas's telemedicine system has evolved since 2003 from a support mechanism for high-risk pregnancy consultations to an initiative that spans medical specialties, including asthma care, pediatric cardiology, gynecology, and mental health. The system has also expanded care to diverse populations, including incarcerated women and people with HIV/AIDS. This article describes the system's evolution, organization, and diverse activities. It also shows how telemedicine can have a positive impact on a rural state and how such a state can become an engine for change regionally. The Arkansas telemedicine system faced classic challenges to uptake and function, in building and sustaining funding, in obtaining insurance reimbursement for services, and in educating patients and providers. The system's impacts on health outcomes and medical practice culture have also reached beyond patient care and provider support. The existing yet continually evolving telemedicine infrastructure and partnerships in Arkansas will respond to the state's inevitable health care reform adaptations from the Affordable Care Act and could provide direction for other states seeking to adopt or expand their telemedicine efforts.