Telemedicine gains support from allergist, immunologist organization

By Dave Muoio

Telemedicine received a nod from the American College of Allergy, Asthma and Immunology (ACAAI) in the organization's latest policy paper, which noted the care delivery platform’s capacity to improve allergy patients’ adherence, costs, outcomes, and access to care.

The paper, published in the Annals of Allergy, Asthma, and Immunology, includes a list of 14 positional statements from the organization’s telemedicine taskforce, among which are recommendations on telemedicine adoption, platform development, and policy for US allergists.

“Telemedicine services are designed to provide high-quality care, including making every effort to collect accurate and complete clinical information during a visit,” Dr. Tania Elliott, lead author of the position paper, said in a statement. “Having mechanisms to facilitate continuity of care, follow-up care, and care coordination is vital. Allergists need to know the policies, regulations, and clinical guidelines in offering these services to their patients.”

To develop its guidelines, the organization tasked a team of allergists with telemedicine experience to conduct a literature search of relevant studies and positional papers from other medical specialties that could prove relevant.

The taskforce came up with a number of benefits and challenges posed with the use of telemedicine within allergy and immunology. Among the former were reductions in the cost of care, improved health outcomes, patient satisfaction, coverage parity, and quicker and more consistent access to small pool of specialists.

“With approximately only 3,000 active allergists nationwide, telemedicine offers the opportunity to provide scalable, longitudinal, high-quality care to patients,” the ACAAI’s representatives wrote.

Potential difficulties related to integrating telemedicine into an allergy and immunology practice extended further. While these included concerns about the technology — such as having backup devices on hand, or ensuring the safety and sanitation of devices — and the strength of digital relationships between physicians and their patients, the authors detailed numerous pitfalls that could occur due to red tape. Specifically, they pointed out difficulties regarding credentialing and privileging, accreditation, confidentiality, reimbursement, and legislative regulations that specialists leveraging telemedicine could face.

“Today telemedicine can be found in every state of the union and almost every country in the world, but in the United States it continues to be hindered by policies that are no longer functional, especially those related to rules and requirements for reimbursement and interstate licensure and practice,” they wrote. “The ACAAI supports continued efforts by state, federal, and other associations to responsibly expand telemedicine practice, including allergy and immunology practice, with ongoing assessment of regulations.”

With these concerns in mind, the ACAAI’s taskforce developed a set of 14 position statements related to telemedicine in allergy and immunology care. Among these were recommendations that telemedicine activities should account for varying literacy and technologic competence; that quality assurance measures be in place for patient satisfaction, physician performance, and outcomes; that live video visits should be held to the same standards as in-person visits, both in terms of quality and reimbursement; and that further research into the effect and outcomes of telemedicine will be needed due to its likely expansion within these specialties.

“The practice of telemedicine will require ongoing updating of policies, regulations, and clinical practice guidelines,” they wrote. “The ACAAI will also need to monitor this rapidly changing landscape to ensure provision of high-quality care to the patient with allergic and immunologic disorders and consistency of practice in an era of futuristic technologies. Despite the challenges, the current and future benefits of telemedicine are promising and exciting for allergists, patients, and health care systems.”