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Published 20150904

ProprietaryIntelligence
Company

Growingtelemedicinereimbursementcouldattract
CROsandclinicaldataproviderinterestexperts
CMS,UnitedHealthcareandWellPointamongUSpayersreimbursingtelemedicine
CROscouldoffersupportiveserviceswithdatamanagementandmining
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executive

GrowinglevelsofreimbursementfortelemedicineintheUScouldspurclinicalserviceprovidersandCROstoconsiderturning
trialtechnologiestogeneralhealthcareusageandfilldatarequirementgaps,accordingtoexperts.

AmericanWellCorporation

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Clinipace

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CollaborativeMedicalTechnologyCorporation
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(Cmtc)
DoctorOnDemand

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Healthtap

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Hexl

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MdliveInc

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MedidataSolutions,Inc.

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OracleCorporation

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Reltio

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TeladocMedicalServices,Inc

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UnitedHealthcareServices

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Wellpoint,Inc.

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Topic
CROInvitation

Telemedicinevisitsareelectroniccommunicationsforinstancevideocallsbetweenspecialistphysiciansandpatients,said
RichardKimball,CEOofhealthcaretechnologycompanyHEXL.Typically,telemedicinehasbeenusedforspecialistvirtualvisits
withpatientsinremoteareaswhowouldotherwisebeunabletoattendsuchconsultations,JamesStansel,partneratSidley
Austin,said.Inthesecases,thepatientmuststillattendanearbyclinictotakethevideocall,hesaid.
However,thereisnowmoremovementtowardCentersforMedicare&MedicaidServices(CMS)reimbursingtelemedicineina
homesettingandwideningthescopeofindicationsthatdoctorscantreatthroughtelehealth,includingrecentprovisionsfor
remotechroniccaremanagementundernewcurrentproceduralterminology(CPT)codes,Kimballsaid.Doctorswouldget
paidaroundUSD43toUSD57achroniccarevisit,accordingtoa31October2014documentonMedicare's2015physician
paymentrules.

HealthcareServices
MergersandAcquisitions
Partnerships/Licensing
Reimbursement
KeyOpinionLeaders
JamesC.Stansel

Executives
ShimonSchurr

CMStendstoleadreimbursementdecisionsthatofteninfluencecommercialUSinsurersandthismaytriggermorepayersto
reimbursetelemedicinedoctorvisits,Kimballsaid,notingUnitedHealthCareisalreadydoingso.InanApril2015pressrelease,
Unitedannounceditwillcoverrealtimevideobasedvirtualphysicianvisitsviamobilephone,tabletorcomputer,withthe
patientabletogetprescriptionsforsuchminormedicalneedsasallergies,sinusandbladderinfections.WellPointcovers
telemedicineincertainplanswithaviewtoprovidingitinallcoverage,accordingtonewsreports.Itisalsonowarequirement
in24statesandtheDistrictofColumbiarequirethatprivateinsurerscovertelehealththesamewayastheycoverinperson
services,accordingtotheAmericanTelemedicineAssociationwebsite.
CROandotherserviceproviderinvolvement

MarkShapiro
MichelleMarlborough
RichardKimball
RamonChen
Country
USA

IntelligenceGrade
Strongevidence

Withthisboostofuseandinsurersupportofthesystem,thereispotentialforCROsandotherserviceproviderstomoveinto
telemedicineofferings,theexpertssaid.

EmailAnalyst

Electronicmedicalrecord(EMR)providersandCROswithdatamining,managementandstoragecapabilitiesbuilttobe
compliantwithHealthInsurancePortabilityandAccountabilityAct(HIPAA)privacylawscouldseetelemedicineasanew
businessopportunity.ThiswasagreeduponbyKimball,SimonSchurr,presidentofUShealthinformaticscompany
CollaborativeMedicalTechnologyCorporation(CMTC),andMichelleMarlborough,vicepresident,productstrategyforcloud
basedclinicalserviceproviderMedidataSolutions(NASDAQ:MDSO).
ProvidingtelemedicineservicescompliantwithHIPAArulesisnotjusthavingasecureline,butalsoprovidingdocumentation
forpatients,gainingagreementfromdoctorsandhandlingthedatainasecuremanner,Schurrnoted.Thishasthepotential
tobeappliedinclinicaltrialvisits,Marlboroughsaid.
SchurrandKimballnotedthatsomegeneralhealthserviceprovidersalreadyhaveofferingssupportiveoftelemedicinesuchas
Teladoc(NYSE:TDOC),MDLIVE,AmericanWell,HealthTapandDoctoronDemand,whichisworkingwithUnited.Therecould
beconsolidationamongtheseplayerswhichhasnotoccurredsofarsincethespaceisrelativelynew,Kimballsaid,pointingout
thatacoupleofcompanieswillbecomebigplayersintelemedicinewhileotherswilldropout.
However,theseexistingprovidersstillhavegapsintheirofferingssuchascombiningfragmentedinformationfromapatients'
varioushealthcareprovider(HCP)visits,saidSchurrandRamonChen,VPmarketingforcloudbaseddatamanagement
providerReltio.Thisiscrucialsincedoctors'timeintelemedicinevisitsiscompressedsotheyneedtherightdataattheir
fingertips,bothnoted.ThisiswhereCROsandthoseprovidingclinicaldataservicescouldbranchoutandfillthebreach,said
SchurrandChen.CROscouldtakea"backdoorentry"intothemarketbyfacilitatingintelligentinformationsharingwhich
couldaidteleconsultation,Schurrnoted.
ItwouldbepossibleforaCROwithelectronicdatacapturetechnologytoapplytheirplatforminthegeneralhealthcarespace
tocaptureinformationorfootagefromvideocallsandstoreitinaHIPAAsecureway,aswellashandlingauditing,forinstance,
Marlboroughsaid.Forinstance,videoconsenttoolscouldbeappliedtothis,sheadded.
However,MarkShapiro,VPofclinicaldevelopmentatUSCROClinipacesaidCROsturningtheirofferingsfromclinicaltrialsto
thewiderhealthcarespacewouldlikelyinvolveawholenewlevelofsoftwarevalidationasthegeneralhealthcaresettinghas
separateregulationstoclinicaltrials.SincethegeneralhealthcaresettingisoutsideofCROs'corebusiness,thismaynotinterest
manyCROs,hesaid,notingthiswouldlikelybethecasewithClinipace.Workinginthetelemedicinespaceinthegeneral
healthcaresettingwouldnotbenaturalgrowthforCROs,Schurragreed,thoughbothheandMarlboroughnotedearlytakers
couldbenefitfromitsgrowth.
CROscouldspinoutdataplatformsforthepurpose,ShapiroandKimballsaid.Thoughbothnotedthereareprobably
technologycompaniessuchasthosedealingwithEMRbettersuitedtotelemedicineneeds.
EMRproviderscould,forinstance,partnerwithbigITplayerswhichhaveexistingvideoconferencingtoolslikeSkype,Webex
orMicrosofttointegratetheirtechnologies,Shapirosaid.CROsontheotherhandarestillintegratinginformationfromEDC
systemsanddatamanagementtoolssoaddingavideocallingcomponentmaybeasteptoofar,headded.

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CompaniessuchasOracle(NYSE:ORCL)andMedidatawhichspecialiseindataservicescouldpotentiallylookattelemedicineas
anewbusinessventure,Shapirosaid.ThoughthekeyfocusisclinicaltrialsforMedidataatthistime,Marlboroughnoted.
HealthcareITvendorssuchasthoseworkinginradiologyandotherconglomeratehealthcareITwouldalsobeinterestedin
telemedicine,Schurrsaid.
byNatalieMorrisoninLondon

AboutNatalieMorrison

Emailthejournalistteamateditorialfeedback@biopharminsight.com

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