The consensus among physician and healthcare IT leaders who met at the New York Health IT Summit to discuss the newly emerging telehealth paradigm was pretty clear—telehealth will change how physicians practice medicine, and healthcare organizations beginning to test the waters now will have a competitive advantage in the future.
The panel discussion, held at the Convene conference center in New York City's downtown financial district, was part of the New York Health IT Summit, sponsored by Healthcare Informatics, and included industry leaders familiar with telehealth platforms: Rahul Sharma, M.D., emergency physician-in-chief, division of emergency medicine, New York Presbyterian-Weill Cornell Medical Center; Mony Weschler, chief and senior director, applications and innovations strategy, Montefiore-Information Technology, Montefiore Health Systems and Todd Ellis, managing director at consulting firm KPMG. The panel discussion was moderated by Healthcare Informatics Editor-in-Chief Mark Hagland.
Framing the current telehealth landscape, Hagland said in contrast to 20 years ago when telemedicine was primarily considered a technology to connect rural physicians to urban specialists, today telehealth has not only matured but is becoming integral to care and wellness for managing population health across regions and the community.
“We have had this emerging population health concept, and, at the same time, we’re also seeing an explosion in the evolution of consumer-facing devices and we’re also moving inexorably from inpatient to outpatient care, even into the home, so now we have an interesting convergence of all these concepts and now we are no longer talking about telehealth just for rural physicians,” Hagland said. “How do you see this landscape evolving and all these different concepts coming together?”
“It’s interesting when you look at the healthcare landscape and you take a closer look at CVS, Walgreens and Walmart as they are getting into the healthcare business. The demand is there on all fronts, from the physician perspective, from a patient perspective and from payers,” Ellis said.
There is a lot of research indicating the benefits to telehealth and telemedicine, Ellis said, and he cautioned that “those organizations taking the ‘wait and see approach’ need to re-look at telehealth and see how it can help them.”
Sharma with New York Presbyterian-Weill Cornell Medical Center said despite the passage of the Affordable Care Act which has enabled more people to get insurance and has resulted in a greater demand for primary care services, there also continues to be tremendous demand for emergency care services as well.
“Last quarter, we had the highest number of visits ever to our ER,” he said. “One thing that has changed dramatically in healthcare is that the government now is really focused on the patient experience and what patients say about their healthcare, and then linking it to financial reimbursements for hospitals. It matters what experience patients have.”
In order to provide patients who visit the emergency room more options for how they receive care, New York-Presbyterian health system launched, just two months ago, a digital health platform, called NYP On Demand, providing virtual emergency room visits with the goal of reducing wait times in the emergency department and providing patients more convenient care options.
“We launched a pilot telehealth program so when a patient comes into the ER, they have the option of a virtual visit through real-time video interactions with a clinician after having an initial triage and medical screening exam. So they go to a private room and see a clinician via a telehealth monitor,” Sharma said.
He continued, “The analogy we use is that years ago there were banks going up on every single street corner, and then the banks all put in ATMs. And people said that’s crazy, why go to ATM when can go to the teller? It’s the same concept. We’re allowing patients a choice in how they get healthcare.”
To date, there have been 160 patients enrolled in the ER telehealth pilot with average wait times of 30 minutes, from the time patients come in to discharge, Sharma said.
“Patients love it and we’ve gotten great feedback. We’re responding to what patients want and we’ll soon have an app,” he said. “In order to be competitive, if you’re not doing it, the competitor down the block is doing it as consumers are driving how they are seeking healthcare.”
Health systems also are partnering with pharmacy retail companies, such as CVS and Walgreens, to provide virtual care with a health system clinician when the on-site pharmacist is not able to provide appropriate care, Ellis noted. “The leading healthcare organizations are talking about access to care, and how do you get a patient into an organization. There are unique things that healthcare systems are doing now with those access points to get that patient into their respective organization.”
Regarding the policy landscape, Sharma said there is work going on behind the scenes at the legislative level to provide reimbursement for telehealth visits. “Under fee-for-service, telehealth is only covered if it’s in a rural area, or it’s a participating Medicare facility, but I think that’s going to change in the next several years or even in the next several months as more people are embracing telehealth because it’s cost effective and also it’s really about quality of care. If a patient goes to the ER, the minute they get admitted they have an increased risk for hospital-acquired infection. Telehealth is a great way to help prevent these costly hospitalizations.”
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