Telehealth,it is rapidly invading the healthcare industry.
A decade ago, delivering medical care over telecommunication technology was a revolutionary thing and seen as irresponsible, but the rise of high-quality video cameras has increased the possibilities, according to Roy Schoenberg, MD, co-founder, president and CEO of American Well, a Boston-based telehealth company. He says the company, founded in 2005, has ridden the wave of healthcare digitization and adapted to the environment, contracting with insurance companies and healthcare providers to make telehealth platforms available to more than 3 million patients.
"What we thought was great promise ten years ago and what was an interesting implementation two years ago has become a tsunami," Dr. Schoenberg says.
1. Telemedicine and telehealth are not the same. Telemedicine is the communication of medical information over telecommunication, connecting physicians through technology, Dr. Schoenberg says. Telehealth, on the other hand, allows patients to request appointments and receive care through telecommunication technology. The two are used interchangeably, but telehealth is the more practical approach because it allows the technology to reach far more people, he says.
2. Telehealth is becoming increasingly accepted by payers. Payers can see the efficiency of how many patients can be seen by physicians through telehealth and are increasingly supporting parity laws in states across the U.S. Many have already agreed to cover telehealth, but the parity rules declare in-person and telehealth visits must be billed the same. The laws are still controversial, Dr. Schoenberg says, but the sentiment is a positive development for the growth of telehealth.
3. The adoption rates are expected to accelerate. A 2014 Towers Watson analysis of current market trends predicted telehealth adoption rates would increase to 37 percent within two years from approximately 22 percent today. Dr. Schoenberg says this will drive the market and healthcare organizations to view it as more essential.
4. Adoption is potentially spurred by reimbursement possibilities. Physicians currently communicate with patients a fair amount over the phone, calling back lab results and asking questions, for which they are not paid. The ability to be paid for the time they spend consulting patients via telehealth and the efficiency of seeing so many more patients while expending fewer resources will help speed adoption, he says.
5. The Department of Veterans Affairs can draw great benefits from telehealth. The VA has more patients than physicians. Increasing the number of providers that can see VA patients — who are often elderly and have a difficult time reaching the hospitals — would help alleviate that mismatch.
6. Hospitals are nearly all beginning to incorporate telehealth technology. Many hospitals, such as UCSF Mission Bay, are beginning to change their infrastructure to enable telehealth. Dr. Schoenberg said this is trend is likely to reduce readmissions.
7. Telehealth has to be conducted through video. In the case of Teladoc, a phone-based medical consultation company which was recently the subject of a court case in Texas, the physicians did not physically see the patients. Dr. Schoenberg says he agrees with the court's decision to ban telephone prescriptions because physically seeing the patient is a critical part of telehealth.
8. Patient-centric and revenue-centric are becoming the same. Now that value-based care is becoming a pillar of service, healthcare executives must remember that prioritizing revenue before patients may actually have the opposite effect — it will damage business because the organization's performance will suffer in the eyes of consumers, Dr. Schoenberg says. When deciding on technology and services, the patient's opinion should always come first, he says.