Peter Rasmussen, MD, is among the champions of virtual care. Over the past six years, he has lost count of the number of patients he has treated in virtual settings.
“Because the vast majority of patients I see in the outpatient environment absolutely don't need to be in person with me,” he told Becker’s Hospital Review. “It made no sense for me to have patients come from hundreds of miles away to get my opinion about their concern when we could have the exact same results through a virtual visit.”
“As a neurosurgeon, what I really need for the most part is to be able to talk to the patient and look at patient images. Rarely do I ever need to conduct a physical exam. So, the telehealth service is better for me, more efficient for me and better for the patient for multiple reasons.”
Up until Jan. 1, Dr. Rasmussen was the medical director of digital health at Cleveland Clinic. Since then he has transitioned to serve as the chief clinical officer of CCAW JV, which is owned by Cleveland Clinic.
Below, Dr. Rasmussen discussed Cleveland Clinic’s strategy to grow digital health as well as the future opportunities for telehealth.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Since 2014, when Cleveland Clinic launched its virtual visit services, how has the technology evolved?
Dr. Peter Rasmussen: Speaking from an isolated standpoint just around virtual visits in terms of the technology engaged being the audio and visual interaction, the technology hasn't changed that much other than its more stable and robust in its ability to maintain an effective encrypted, confidential connection. What's probably changed more dramatically are the other advances of digital health and the digitization of healthcare that has allowed for the expansion of virtual care.
As a whole, the interoperability of healthcare has gotten much better in the last six to eight years. This has allowed clinicians the ability to deal with complex medically ill patients because they have better access to patient medical records. There is much more interoperability between laboratory systems in the EHR, generally. Additionally, there is better portability of medical images, including how images are acquired and transferred between remote caregivers. Because you can pull all of these data sources together more easily, you can interact with a more complex patient at a distance.
A lot of telehealth and virtual health got started with relatively simple things, such as urgent care visits. And that is relatively straightforward because it's an isolated interaction with a patient. But now we can begin to do much more complex things with patients because we have broader access to their medical records.
These tools have also led to an increase in the ability to deliver second opinions for complex patients, including cancer, cardiac and neuro patients.
Q: What has been Cleveland Clinic’s strategy to grow its virtual care and digital health?
PR: It's a complicated question because from a business standpoint it makes sense to strategically leverage your best assets. But that all has to be tempered with a patient and physician adoption. It would be easy to say that we were going to leverage the brand and the notoriety of the heart and vascular institute to really build out access to patients and deliver care at a distance. However, the physician adoption in that area has been slower in that area. So, a lot of the strategy was building out a proper digital health platform that allows us to deliver care at a distance even for complex patients. And then let's figure out where the patients' populations and physicians that are interested in leveraging the platform.
Q: How do you motivate other providers and patients in general to use virtual care solutions?
PR: It's like everything else in the world: Whenever there is a new technology there are the early adopters, the extreme laggers and the other people who are waiting for the early adopters. That is very similar to telehealth. It was a lot of evangelizing and going out and talking to as many physicians and medical leaders as I could to explain the possibilities of telehealth. There are a lot of physicians that have cracked into the concept of consumerism. This is particularly about surgeons who offer niche-type procedures, and they immediately grabbed on to telehealth as a way to provide access to patients and as a marketing tool.
Now we are getting past that phase, and a larger body of physicians are recognizing that telehealth is inevitable. They are getting more on board as the patient expectation is becoming so high.
Q: Looking ahead, where do you see virtual care and telemedicine heading?
PR: I think we are going to see the decreasing separation between traditional healthcare and telehealth, and it will become a blending of just care. A fair amount of care will just be delivered through telehealth means. Additionally, I think there will be a reduction in the episodic nature of care, where you have short boosts of care that are being delivered in person. Instead, more longitude care will be delivered through the utilization of connected devices.
One of the growing areas of telehealth in the country is for medical second opinions. Patients should recognize that nationally on average when they receive a diagnosis for a complex disease that a quarter of the time the diagnosis is incorrect. A significant percentage of the treatment strategies are then also incorrect. Patients should take advantage of using remote services to seek out these second opinions.