Telehealth seems amazing, right? So then why isn't every hospital and health system adopting telehealth? Well, there are a few logistical issues with implementing telehealth. First and foremost, is the cost. It is extremely expensive for a hospital, who already runs on extremely low operation margins (1-3%), to research, design, implement, and practice their one unique telehealth system. The reason that there has to be research and design, rather than implemeneting a pre-exisitng system, is that each hospital serves different needs. For instance, rural hospitals serve different demographic needs than an inner-city hospital. Additionally, for rural-specific hospitals, sometimes their band-width is not large enough to host as big an online system as telehealth. Internet may already be scare in rural America, and implementing a huge system may not be feasible. 

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Another reason that telehealth may not be implemented is due to our reimbursement system. I have attached a video below to explain the basics about healthcare reimbursement. It pertains to telehealth specifically because telehealth is such a fast growing industry, in fact, it is growing faster than insurance companies can keep up. Each hospital service has a negotiated premium, co-pay and reimbursement rate, set between the hospitals and various insurances. However, how do companies negotiate a non-hospital, but health-realted service? That's where it gets confusing. And the experts are still trying to figure it out! How much should be reimbursed or charged for a phonecall? What about for a videovonference? And for sending a dance therapy video link? The insurance negotiations are happening, but at a slower rate than telehealth is being improved. Therefore, the lag time inbetween the theory and execution of proper telehealth, is what causes some facilities to be hesitant to implement telehealth. 

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