In a recent survey conducted by Harris Poll and commissioned by American Well, a telemedicine technology provider, 20 percent of consumers said they would switch their current primary care provider (PCP) if another PCP in their area offered telehealth visits. Among the 4,000 respondents to the survey who have a primary care physician, 65 percent said they were interested in seeing their PCP over video. Parents with children under 18 are even more likely to say they’re interested, with 74 percent interested in seeing their PCP through telehealth, according to the survey.
Telemedicine is not a new technology; in fact, it’s about 40 years old, according to Jonathan Linkous, CEO of the American Telemedicine Association (ATA). All the same, the use of telemedicine is accelerating very rapidly. “After decades of experimentation and pilot projects, we’re over the point of no return. I think we’re over the tipping point and we’re now at the point where it’s starting to transform health delivery.”
There is ongoing discussion about the consumerization of healthcare, and that impact is being felt now at healthcare organizations across the country, as consumer demand for the convenience of virtual visits and digital services is driving this acceleration of telehealth services.
“Consumers are very aware of the technology that is available. They see it on their smartphones every day. There is a growing expectation, then, that their healthcare providers are going to make use of this technology to advance the way that care is delivered,” Alan Perkins, principal at The Chartis Group, a Chicago-based healthcare consulting firm, says. The healthcare industry is hitting an inflection point where patient care organizations are now essentially competing with retailers, such as Walgreens and CVS, that are now offering telehealth services.
And while there continue to be barriers to telemedicine adoption, Perkins cautions, “Providers can’t wait for all the reimbursement or technical issues to be resolved, or they will be left behind as this consumer-driven change alters the healthcare landscape.” He adds, “So the providers that have been taking a wait-and-see approach, they need to start working now on an enterprise telemedicine strategy. A robust telehealth capability takes time, and as consumers increasingly come to expect these services, health systems need to be ready, and they need to be planning now.”
At the same time, there are rapid technological advancements as electronic medical record (EMR) vendors are building telehealth capabilities into their current EMR applications and into their native workflow designs, says Carl Dolezal, associate principal at The Chartis Group. “We have changed the landscape to the point where technology is no longer the barrier, but the enabler. Historically, we have struggled with stitching together networks and applications, and integrating devices with EMRs in the provider space. Developing telehealth through these systems that were, for the large part, not intuitive. But now with improved telehealth application capabilities and integration, some of which have actually been developed and supported by the EMR vendors, information is available with telehealth tools within their standard workflows, and that’s very important.”
For many patient care organizations, telehealth and RPM technologies are becoming just another tool in the toolbox for providing patient care. Health systems and providers using telehealth and RPM technologies are reporting significant benefits, in terms of improving patient care and lowering costs. Tele-ICU is now widely implemented, with about 30 percent of ICU beds in the U.S. connected to remote monitoring technology, Linkous says, and studies have shown that tele-ICU helps to reduce length of stay and improve patient outcomes.
At the Phoenix-based Banner Health, a 28-hospital health system, healthcare leaders built an in-home telehealth program targeting a subset of patients with complex chronic conditions following a successful tele-ICU program. The in-home telehealth pilot program, called the Intensive Ambulatory Care (IAC) program, focuses on the system’s most complex population, those diagnosed with five or more chronic diseases, according to Deb Dahl, vice president of patient care innovation at Banner Health.
Banner Health and its vendor partner, Royal Philips, studied the impact of the IAC telehealth initiative on patient outcomes, and the results showed significant decreases in patient healthcare costs and hospitalization rates. Specifically, an analysis of patient results over the first full year of the in-home AIC program revealed that the program helped to reduce overall costs of care by 34 percent, reduced hospitalizations by 49 percent and reduced the number of days in the hospital by 50 percent. Prior the program, there were 10.9 hospitalizations per 100 patients per month; after enrollment in the program, the acute and long-term hospitalization rate dropped to 5.5 hospitalizations per 100 patients per month. Additionally, Banner Health saw the 30-day readmission rate for that patient population drop by 75 percent—from 20 percent prior to enrollment to 5 percent after program enrollment.
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