As I started to write one of our annual Tech Trends piece last year about why 2013 might be the year of telehealth, I got a quick reminder from Rob Sprang, director of Kentucky Telecare and co-project manager of the Kentucky TeleHealth Network, not to jump the gun.
“Every year we seem to say this is the year of telehealth,” he told me. “In the early days there were technology challenges. We were trying to do things beyond the scope of the technology. But the technology now has outpaced the application of it. The technology is not what is holding us back now.”
So what is the problem with telehealth? “Reimbursement, reimbursement and reimbursement,” Sprang said.
Well it may be that the business models are starting to catch up to the technological advancements. We noted yesterday that Mercy was breaking ground on what it calls the first U.S. “virtual care center.” The St. Louis-based Catholic health system estimates that the center will manage more than 3 million telehealth visits in the next five years.
That is why I am excited to be attending the American Telemedicine Association annual meeting in Baltimore May 17-20. When I looked beyond the inspirational keynote addresses to the concurrent session descriptions, I sensed that there has been a real change in how seriously the largest health systems in the country are taking telehealth initiatives. Below are descriptions of just a few sessions that illustrate what I am talking about. I plan to report on some of the participants’ observations for Healthcare Informatics next week.
• How to Reach Scale with Virtual Home Care Visits
Clinical and IT leaders from Partners Healthcare, Mayo Clinic, Joslin Diabetes and the National Parkinson’s Foundation will discuss business models to achieve scale in virtual home care visits. The use cases for conducting virtual visits has evolved from caring for patients with acute conditions in the hospital and or clinic setting to reaching patients in their homes for post-discharge follow-up, chronic disease management, behavioral health counseling, pediatric services, general health and wellness and more.
• Build It or Buy It? Establishing a Telehealth Platform
Kim Henrichsen, vice president of clinical operations and chief nursing officer at Intermountain Healthcare in Salt Lake City, will talk about how Intermountain identified telehealth as a necessary technology to support the improvement of care they provide to patients throughout the health continuum. Intermountain evaluated whether to buy an existing telehealth solution or to build it in-house. This evaluation includes multi-dimensional considerations for the clinical design, staffing needs, information systems, artificial intelligence, technical hardware, and implementation. Intermountain has elected to build based on current capabilities. The need for flexibility in future applications of the telehealth technology and the cost associated with purchasing a market product were primary considerations. Intermountain’s belief and vision is that this system will be more advanced and go beyond any existing commercially available alternatives
• Advances in Telepsychiatry
This panel discussion will describe how four academic psychiatry departments have incorporated telemedicine elements. Faculty representatives from the Universities of Florida, Louisville, Maryland, and Tulane will each present an overview of their department’s telepsychiatry initiatives. They will discuss the ways in which program sustainability has been ensured through successful approaches to program funding.
• TeleRounding: Extending the Clinical Expertise of an Academic Medical Center into an Urban Rehabilitation Hospital
Massachusetts General Hospital (MGH) and Spaulding Rehabilitation Hospital (SRH), two urban medical institutions separated by 2.2 miles, embarked on a new model of patient rounding using telemedicine in the spring of 2013. Over a 4½-month pilot, 17 thermal injury patients participated in 45 telemedicine consults. During the course of the pilot, financial and operational efficiencies were realized by both institutions, as well as improvements in patient satisfaction and continuity of care. Improvements realized by MGH included: decreased re-admissions, shorter consult times, reduction in resource utilization in the outpatient clinic, increased inpatient and outpatient capacity, a reduction in provider travel and an increase in quality and consistency of communication that resulted in strengthened relationships among providers. SRH achieved gains in: elimination of patient transport associated with appointments to the outpatient center, institutional reduction in expenditures, increased clinical education of care providers, elimination of re-admissions associated with operative procedures, increased adherence to the patients’ rehabilitation schedules, expedited patient throughput and increased inpatient capacity.
