Most healthcare practitioners are either using telemedicine or planning to use it soon, but less than a fifth of them are being paid for those services.

That's according to a survey recently conducted at the Academy of Integrative Health & Medicine (AIHM) annual conference in San Diego. AIHM surveyed 754 practitioners, 78 percent of whom were physicians. Neither the academy nor the conference is specifically focused on telemedicine or technology, but rather on acute care, a spokesperson told MobiHealthNews, so there is no obvious sampling bias toward telemedicine.

Overall, 33 percent of physicians surveyed said they were using some form of telemedicine and another 29 percent said they were planning to, making a total of 62 either using or considering telemedicine, defined as "care via telephone, video visits, web cam visits – or other consultations not in person".

However, when practitioners were asked "[d]o you have a mechanism to get paid for telemedicine services -- are you in a network that will reimburse for that?", only 19 percent said yes. 

“When we have technology that can drive down the cost of health, and help improve patient outcomes, providers need to be reimbursed," Nick Jacobs, a board member of AIHM, said in a statement. "In this case, 33 percent of physicians are delivering service using telemedicine right now, yet just 19 percent say the service is covered. We find the same issue in integrative care – where for example, acupuncture, proven effective, is not covered by some health insurance providers. We need to open up all the options for healthcare to providers and patients. It drives down costs and improves patient outcomes.”

Survey participants were asked whether they thought telemedicine technology was ahead of the state medical board guidelines used to regulate it. A majority -- 56 percent -- said it was, 34 percent said it wasn't, and 10 percent weren't sure.

Additionally, doctors were asked what percentage of initial and follow-up visits they conduct are appropriate for telemedicine. Doctors were much more likely to consider telemedicine for follow-up visits -- 68 percent of doctors said that zero percent of initial visits were appropriate for telemedicine, and another 18 percent said one fifth or less of initial visits were appropriate for telemedicine, whereas only 8 percent said zero follow-up visits were appropriate. A plurality (29 percent) said between 1 and 20 percent of visits were appropriate for telemedicine, 24 percent said 21 to 40 percent would be appropriate, and 21 percent said 41 to 60 percent would be appropriate.

Telemedicine reimbursement is gradually gaining steam. Just this month CMS released a final rule that will expand the range of telehealth services that can be reimbursed under Medicare starting in 2015. In July a House bill was proposed that would also expand reimbursement by Medicare; it's currently in committee.