Once the realm of science fiction, telemedicine has become a reality of health care –– and an option for patients who might once have been difficult to reach, according to an article posted on the HealthLeaders Media website. San Francisco-based Dignity Health, for example, performed 12,000 telemedicine consults in 2015 — a number that is expected to increase to 20,000 in 2016.
But telemedicine is changing, says HealthLeaders columnist Lena J. Weiner, and providers must be ready to exploit its possibilities.
1. Virtual Visit Volumes Are Growing
In the opinion of Deborah Dahl, vice president of care innovation at Banner Health in Phoenix, Arizona, many traditionally brick-and-mortar services, such as visits for routine acute care, follow-up care, e-pharmacy, and counseling, are poised to move online.
While Dahl’s sentiments may not be typical (telemedicine appointments are generally not reimbursed by the Centers for Medicare and Medicaid Services or most other payers), providers are paving the way for virtual visits to become the norm, Weiner writes.
“I think more urgent and follow-up care will shift to the virtual space in the near future,” said Peter Rasmussen, MD, medical director of distance health at the Cleveland Clinic.
He predicted regular online patient visits with a care coordinator or nurse for health maintenance, and visits to a clinic or doctor's office only for hands-on visits, such as eye examinations, throat cultures, and a comprehensive physical exam every year or two.
2. Improved Patient Monitoring Allows Faster Interventions
Being able to reach patients in their home environments has distinct advantages, such as enabling providers to intervene early and influence better outcomes, according to Dahl.
Patients with multiple chronic conditions often take numerous medications that have not been checked for interactions or even for necessity. To verify the necessity and safety of all medications, pharmacists at Banner Health interact remotely with patients via a camera on a tablet or mobile phone and have them go through the medications they take regularly, Dahl explained.
OSF Healthcare in Peoria, Illinois, uses a telemonitoring application that gathers data from electronic medical records and bedside monitoring systems. The app allows clinicians to see subtle changes in the patient’s condition that otherwise might go unnoticed, Suzanne Hinderliter, RN, explained. She said that OSF has seen a 26% decrease in mortality and a 20% decrease in length of stay since the facility began using telemonitoring technology.
3. Partnerships Can Lower Costs
In telemedicine, partnering “is almost mandatory,” according to Cleveland Clinic’s Rasmussen, whose organization partners with American Well for technology infrastructure and supplemental clinician staffing. The cost, he said, is “not an insignificant sum… [but] I don't think we could do the same [in-house].”
OSF has partnered with Carena, a telemedicine provider in Seattle. “We were looking for someone to partner with us, not just provide service. Carena has been very collaborative,” Hinderliter said.
In her opinion, the greatest advantage of partnering has been that the infrastructure has already been built, which reduces costs. “If we’d had to build completely in-house, it would have been a lot more.” Even when paying clinicians the same hourly wage as an in-house employee, supplemental staffing through a partner is less expensive.
Source: HealthLeaders Media; January 21, 2016.