Thanks to the existing technology and patient demand, organizations do not need to wait another five years to adapt telehealth solutions.
Editor’s Note: This article was contributed by Gary Sibley, vice president of sales and marketing at Brother OmniJoin. Sibley has more than 20 years’ experience in the field of collaboration technologies.
The adoption rate of telemedicine technology has increased by about 3.5% annually from 2014 to 2016, to 61.3% in 2016, according to a HIMSS Analytics 2016 Essential Brief1. Adoption remains slow, but why?
From budgetary concerns to not realizing the potential benefits, healthcare organizations can face many obstacles in implementing a telehealth program. The health systems that have begun offering telehealth services through web conferencing technology are finding, however, that many of these initial concerns were unfounded. Patients are highly interested in accessing care through these methods, while changes occurring with commercial and government payers are also alleviating budgetary concerns.
The cloud-based web conferencing technology used in implementing telehealth programs has been especially effective at alleviating budgetary concerns, but also apprehensions among providers that the technology would be too complex to use or would not deliver the desired performance to facilitate quality patient care.
These and many other reasons are why telehealth adoption continues its steady growth rate and the industry is expected to reach $10.5 billion by 20222. Thanks to the existing technology and patient demand, organizations do not need to wait another five years to get started. They can and should get started now. Healthcare providers seeking a telehealth solution can look to the following four sections that explain strategies for overcoming common barriers to telehealth adoption.
1. Building an internal case
Before implementing a telehealth program, health systems need to build a persuasive case to demonstrate that it is worth devoting the precious time and financial resources to make it come to fruition. Often the first question that health systems ask is if patients would access care through telehealth. Although patient telehealth access has already increased 50% since 20133, surveys and results from existing telehealth programs indicate an even greater demand.
Sixty-two percent of consumers of all ages who responded to a June 2016 survey strongly or somewhat agreed that they would be open to virtual care treatment options as an alternative to in-office doctor’s visits for non-urgent matters4. Younger consumers are not skewing those results, either. More than half, 57%, of Baby Boomers aged 55 years and older also agreed. Another noteworthy finding from that survey is that of 52% of Millennials, ages 18- to 34-years old, and 53% of Generation X respondents, aged 35- to 54-years old, reported that they would choose a provider with a virtual care option over one that does not offer telehealth services5.
2. Evidence of clinical benefit increasing
Another question that health system leaders ask is will telehealth services improve clinical quality performance? The answer increasingly appears to be “yes.” In June 2016, the Agency for Healthcare Research and Quality (AHRQ) reported its comprehensive review of published literature on telehealth which found “[a] large volume of research reported that telehealth interventions produce positive outcomes when used for remote patient monitoring, broadly defined, for several chronic conditions and for psychotherapy as part of behavioral health6.”
The AHRQ review also pointed out that the most consistent benefit has been reported when telehealth was used for remote patient monitoring of chronic conditions such as cardiovascular and respiratory disease. The report cited improvements in mortality and quality of life and reductions in hospital admissions due to ongoing communication with providers.
Given that chronic conditions are attributed to 86% of healthcare costs7, cost-effective telehealth interventions could help health systems more efficiently and effectively manage these patients. The resulting reduced costs and better outcomes could also likely improve the organization’s financial performance under value-based payment models.
3. Reimbursement varied, but growing
A major barrier, and one that needs to be overcome for making a persuasive internal case for telehealth, is ensuring adequate reimbursement for the care provided. Payment for telehealth is growing across many fronts, but it depends on several factors. Commercial health plans more often seem to recognize the care quality and cost benefits of telehealth with nearly 60% of the nation’s largest employers offering telehealth coverage, up from 30% the previous year8.
For Medicare patients, the U.S. Department of Health and Human Service recently reported to Congress that Medicare Advantage (MA) plan beneficiaries are often not held to the same narrow reimbursement restrictions of regular Medicare beneficiaries. In 2016, as many as 72 MA health plans were identified that specifically mention covering telehealth for services and/or areas not covered by Medicare’s current telehealth definition9. Medicare reimbursement for telehealth continues to expand with new programs, such as Next Generation ACO, which awards payment for telehealth beyond the geographic restrictions of regular Medicare. This and other pilot programs seem to indicate that the agency is contemplating broader, more lenient telehealth payment terms for all participating Medicare providers.
Meanwhile, 49 states and District of Columbia now reimburse for video visits in Medicaid fee-for-service programs. In 32 states and the District of Columbia, there are parity laws that cover private insurers and reimbursement for telehealth services10.
4. Determining evaluation criteria
Once a strong internal case has been built to offer telehealth services, health systems typically determine the features needed in the web conferencing platform that will be used to support the implementation of the telehealth program.
The first characteristic that most health systems look for in a web conferencing system for telehealth is simplicity. Seeking a secure, cloud-based platform that users need only a web browser and highly intuitive configuration to begin delivering care would likely ensure a more rapid and widespread adoption among time-strapped providers. Cloud-based implementations are also highly scalable across enterprises and carry only a fraction of the costs associated with premises-based servers and in-house software support.
The second essential feature is security. Using 256-bit end-to-end encryption is not only important for protecting the privacy of patient protected health information, encryption is also required as part of the HIPAA Security Rule. Most commercial browsers offer this level of protection for secure connections and are easily accessible to both providers and patients.
Third in the evaluation criteria, and perhaps most important from the patient perspective, is performance. Simply connecting with providers over a web camera is only the minimal requirement. Web conferencing platforms for telehealth need to offer high-definition video and audio quality to more closely simulate the in-person clinical experience and maximize patient satisfaction.
With these web conferencing technology qualities and the growing demand for telehealth, healthcare organizations should easily overcome any concerns or barriers to implementing their own programs. If organizations begin building their internal case now, they can be among the 53% of organizations in 2020 enjoying the care quality and financial benefits of delivering care through simple, safe and secure telehealth technology11.
- FitzGerald, Brendan. “Telemedicine Adoption Continues Growth in 2016 and Beyond.” HIMSS Analytics. April 26, 2016. http://www.himssanalytics.org/news/telemedicine-adoption-growing-35-annually-2014
- Credence Research. “Global Telehealth Market to 2022 – Market Size, Share, Growth, Trends and Forecast: Credence Research.” May 18, 2016. http://www.healthcaredive.com/press-release/20160518-global-telehealth-market-to-2022-market-size-share-growth-trends-and-f-1/
- Gumpert, Kylie. “Telehealth services becoming popular with US consumers and insurers.” Reuters. Dec 23, 2015. http://www.reuters.com/article/usa-healthcare-telemedicine-idUSL1N14B20B20151223
- Salesforce Research and Harris Poll. “2016 Connected Patient Report: Insights Into Patient Preferences on Telemedicine, Wearables and Post-Discharge Care.” June 2016. https://www.salesforce.com/form/industries/2016-state-connected-patient.jsp
- Salesforce Research, et al.
- Agency for Healthcare Research and Quality. “Telehealth: Mapping the Evidence for Patient Outcomes From Systematic Reviews.” June 2016. https://www.effectivehealthcare.ahrq.gov/ehc/products/624/2254/telehealth-report-160630.pdf
- Centers for Disease Control and Prevention. “Chronic Disease Prevention and Health Promotion.” November 2016. http://www.cdc.gov/chronicdisease/
- Japsen, Bruce. “Most Employers Paying For Doctor Telemedicine Visits.” Forbes. October 28, 2016. http://www.forbes.com/sites/brucejapsen/2016/10/28/most-employers-now-cover-doctor-telemedicine-visits/#2f1a9c952226
- U.S. Department of Health and Human Services, Office of Health Policy, Office of the Assistant Secretary for Planning and Evaluation. “E-health and Telemedicine.” Report to Congress. August 12, 2016. https://aspe.hhs.gov/sites/default/files/pdf/206751/TelemedicineE-HealthReport.pdf
- Yang, Tony. “Telehealth Parity Laws.” Health Affairs, Health Policy Briefs. August 15, 2016. http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=162
- FitzGerald, Brendan, et al.