Worker Wariness Stifles Telehealth’s Acceptance

A lot hinges on this question: Do you feel comfortable getting a diagnosis or being treated for a condition by someone on a screen?

Employers love telehealth and insurers love offering anything that their employers want to buy and that—debatably—can save money. One problem: Workers don’t share this enthusiasm, at least not yet.

A survey of 133 large employers (at least 5,000 workers) by the National Business Group on Health (NBGH) found that while 70% of companies offer telemedicine, only 3% of employees use it. The survey looked at the first half of 2016; a new one is coming out in the summer. Last year’s survey predicted that 90% of large employers will offer telehealth services this year, so if lack of employee buy-in worries companies, they’re not showing it.

“It’s still relatively new,” says Steve Wojcik, the NBGH’s vice president of public policy. “It’s a matter of employers communicating and making it as familiar as possible to employees.”

Gamify it

Anthem is taking a hands-on approach through its affiliate LiveHealth Online. A study sponsored by LiveHealth Online that was published recently in the Journal of Medical Internet Research found that telehealth lowers testing rates while maintaining the quality of care. In a press release, the president of the company, John Jesser, said that the study “is a great step in boosting confidence among consumers” in telehealth visits.

“It’s a nice quote, but I’m not sure that this study is going to drive a lot of consumer adoption,” Jesser tells Medical Care. “Consumers don’t follow these academic reviewed medical journals.”

Consumers are mostly won over when they log in on their smartphone or tablet and suddenly see live doctors. “Until you do that, actually go in and have some sort of a visit, you can’t comprehend that you’re carrying around a medical group in your pocket,” says Jesser. Employers don’t have the ability to go one person at a time and demonstrate this sort of digital interaction, however. “There’s a million-and-one things we’re all being asked to do,” says Jesser. “We found that the greatest success comes with some sort of significant prizes, you know, a contest, or you gamify a registration drive.”

Jesser declines to disclose just how many Anthem beneficiaries use LiveHealth Online because “people count in all different ways.” But in general, he says that large employers who don’t actively campaign for telehealth usage might see as little as 2% adoption. It can get as high as 50% for employers who tout the service. “We have people who spend all day working with these employers and they’re coming up with clever and creative ways to engage their employees,” says Jesser.

Still, lack of employee buy-in is enough of a problem that LiveHealth Online is considering conducting a study that essentially asks employees, “Why aren’t you using the telehealth service that’s being offered to you?”

As the NBGH suggests, large employers are where telehealth companies are placing their bets. They can “drive the message,” Jesser says.

Wojcik says that if the employer has an on-site clinic, so much the better. It’s a way for employees who are not on site to access the clinic’s services. Also, any telehealth program that’s designed correctly incorporates the patient’s in-person provider; everything done online gets put into the medical record.

Jesser’s job is to tout the benefits of telehealth, but he recognizes that it’s only a tool. “Let’s be clear: Nothing replaces an in-person physical exam from a physician. To be a health insurance company or an employer and start trying to get into that space and saying, ‘OK, you can’t see a doctor in person,’ you’re not going to see that. There’s no replacement for a good relationship with a doctor.”

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