We recently attended the Telemed Leadership Forum in Washington, DC, hosted by Telemed Magazine with the goal of bringing together telemedicine innovators and thought leaders to cover telemedicine's most pressing issues, for both providers and those interested in investing in digital health. Panels and individual presentations covered a variety of topics; here's what we learned:
Legal, regulatory and policy change is near for telemedicine.
In 2001, regulatory restrictions abounded. In 2018, we see these regulatory hurdles coming down. There are an increased number of bills being introduced into Congress; it is a bipartisan issue that everyone is behind, particularly in the face of promised cost savings.
We're also seeing more demand for direct to consumer care, such as in nursing and home-based care, that includes 2-way video and remote patient monitoring.
In the next decade, it's expected that we’ll see significant expansion in telemedicine, in part pushed by:
- The repeal of the individual mandate, which is expected to have a significant impact on employer-provided care (an estimated increase of costs to employers is projected at 10% year over year)
- This will lead big employers need to figure out a way to increase quality of healthcare and lower costs
- Telehealth and direct contracts with cost-saving vendors is where the majority of these cost savings lie, particularly in the diseases that cost us the most (such as hypertension and diabetes)
Telemedicine Reimbursement is another hot topic; namely, when will we see widespread telehealth reimbursement?
Another common theme: nationwide standards are needed (this is the same barrier to growth seen in other emerging industries, such as cannabis). Due to lack of standards, telemedicine suffers from:
- Lack of training
- No reimbursement
- No quality data to report ROI and other metrics
Building and adopting telehealth programs in your practice: focus on onboarding and interoperability.
For physicians looking to adopt telemedicine into their practice, the importance of building support and understanding among staff prior to a telehealth rollout is critical. This educational phase is an often overlooked element that's absolutely necessary for success. Failures of integration come from telehealth doctors who do not understand the operations of the clinic in which they operate.
When implementing telehealth in your practice, use every vehicle possible to demonstrate the scenarios in which it works for both patient and staff members. Remove or alter systems and structures in place that may undermine the ultimate vision for your telemedicine investment, such as the workflows currently in place.
One more thing that's easy to overlook: realize that new social norms are needed. Change is often difficult, especially the behavioral change that is so ingrained around how we manage and deal with our health.
The hard-numbers-ROI of telehealth is hard to measure.
Though this was a much-covered topic, it deserves brevity when attempting to caption the panels and presentations around it. We can be fairly brief when we summarize the question of ROI in telemedicine: basically, this is a data point that barely exists at this point, and therefore is impossible to accurately state. Everyone wants to know if the promises of increased flexibility and improved patient satisfaction are accurate, but without hard industry numbers, it's a tough metric to calculate. Data is scarce, with the earliest data being from 2015. So, be a part of the solution…track your data. Telemedicine is an investment in the longevity of your business without brick and mortar overhead.
In regard to Telehealth partnerships:
Providers: make sure you are solving a problem instead of being useless tech that won’t be adopted.
Relationships are important to foster and maintain, but the program must SCALE. You must be able to move from relationship to process.
Bigger health systems may have a problem adapting to new processes. Smaller, more specialized clinics are more agile and fluid in adopting new workflows.
What are the the challenges and risks in telemedicine?
First, we need industry-wide, nationwide standards. Without them, forward progress will be slowed. Telemedicine is great for monitoring chronic diseases…but patients will not pay for it. People already spend a bunch of money on health costs, and because of this, will only pay for episodic care. This is where a solution to reimbursement comes to light in it's importance. Reimbursement is key is increasing adoption among both patients and physicians.
People want to see “their” doctor, and they want immediate care. The ER is a last-resort and often the only resort for patients seeking after-hours care. It's ungodly expensive, it's impersonal, it's confusing - but it's there when you need it, and thus, continues to be heavily utilized.
There's no shortage of telehealth solutions in existence, but - second to federal licensing - interoperability is key .
And of course: there's that good old 'resistance to change' we keep mentioning but is worth repeating: cultural change is hard!
We all see the promise in telemedicine, touted as the future of our broken healthcare system. It's arguably the fastest-growing segment in healthcare today. Some of our key takeaways from Telemed Leadership Forum:
- In 5 years, we’ll see consolidation in the industry, so it is important to be involved in the shaping of regulation. As well, we should partner within the industry.
- In approaching provider partnerships, we need to know what problem we are solving, and how we solve it.
- Once we have a partnership in place, the real work begins. Staff onboarding is critical; we must help them understand how it makes their daily workflow easier and better for both patients and staff. We'll say it again: INTEROPERABILITY IS KEY. Our platform must integrate with theirs, otherwise it’s just another piece of useless tech.
- Cultural change is hard! No one wants to adopt a new behavior. But it can't be denied - telemedicine and other digital healthcare solutions are the future of this industry.