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The Tipping Point for Telehealth



There are many good reasons why experts are predicting that 2019 will be a "tipping point" for telehealth— in other words, the year to see telehealth and remote care services gain even more widespread acceptance in health plan networks, practices, and facilities throughout the United States.


Along with many other aspects of telehealth, like remote patient monitoring (RPM) and mHealth, the virtual visit is becoming not just a standard part of the American healthcare delivery, but also a means to boost quality and cost-effectiveness significantly.

So why now? The patient seems to prefer it.


The information from the following surveys fully supports this prediction.


Before looking at the survey findings, let me also add that the new CPT codes finally address the last major obstacle. Now caregivers are being compensated for their efforts which will further drive behavior modification.


The process of utilizing consumer technology to allow patients to confer with physicians and clinicians via video conferencing apps — usually on their (camera-enabled) smartphones and tablets, but also via traditional PCs — virtual visits aren't just a trend, but "part of the shift toward making health care more convenient, and they're already popular,"writes Heidi Godman at the Harvard Health Blog.


So popular that more than half of Kaiser Permanente's physician visits are virtual visits, as the company's CEO stated last year. As Fortunereported, that amounts to more than 110 million interactions between physicians and patients "done via smartphone, video conferencing, kiosks, and other technology tools."


So, why are organizations like Kaiser (among many others) embracing this relatively new method of care delivery? For starters, the implementation of virtual visits has shown to:

  • Reduce costscaused by patients who would otherwise go to the emergency room "because they can't get in to see a doctor," as Ken Terry writes inMedical Economics.

  • Increase access to care, helping to ease the effects of the physician shortage that's gripping broad sections of the United States (mainly in rural areas).

  • Improve chronic disease management, specifically by easing the process of "postsurgical follow-ups or for medication reconciliation after hospital discharge," as Terry points out.


A study published in The American Journal of Managed Carein January 2019 has found that telehealth virtual visits offer a variety of benefits across the care continuum. Specifically, the study authors note that virtual video visits offer "enhanced convenience and reduced travel time" to patients, while clinicians have the opportunity to "enhance connections with patients.

To arrive at these findings, researchers from the Massachusetts General Hospital (MGH) — which has had a telehealth program in place since 2012, and a virtual visit service since 2013 — surveyed 254 of its unique patients and 61 attending physicians "to measure perceptions" of telehealth virtual visits as compared to traditional office visits.


Breaking Down the Findings from MGH's Study on Telehealth Virtual Visits

More specifically, the MGH study on virtual visits found that almost two-thirds of patients (62.6%) and more than half of the surveyed clinicians (59%) found no difference in "the overall quality of the visit,"meaning that, contrary to some lingering misperceptions in the healthcare industry that using telehealth means sacrificing quality of care to some degree.


"The fears of distracted, overwhelmed providers and a loss of human connection between patient and provider have been raised repeatedly with the rising use of computers in the doctor's office," the study authors note. "Interestingly, this issue was not a central concern to participantsin our VVV [virtual video visits] program, perhaps due to the use of VVVs with established patients."


The study's key takeaways also included the findings that:

  • Patients not only highly rated their experience using telehealth virtual visits, but "the majority would recommend them to family and friends."

  • The majority of patients and clinicians "perceived no loss of communication"when using virtual visits as compared to traditional office visits.

  • Patients so valued the added convenience and reduced travel time associated with virtual visits that they reported a willingness to pay additional co-payments for access to the service.

"Clinicians reported that virtual video visits are superior to office visits for timely scheduling of patient appointments (70.5 percent) and visit efficiency (52.5 percent)," according to a news release announcing MGH's Virtual Visits Study.


The news release goes on to add some further details. Among surveyed patients, the study found that:

  • 79% found that scheduling follow-ups were easierusing telehealth virtual video technology.

  • 21% felt that virtual visits offered a better overall quality of care.

  • 68% rated virtual visits at "9 or 10 on a 10-point scale,"with those patients who provided lower ratings generally doing so because of technical issues that immediately resolved with technical assistance.

American Well, the leading telehealth company and partner to more than 70 U.S. health systems, today released the results of its Telehealth Index: 2017 Consumer Surveywhich found that 20 percent of consumers would switch their current primary care provider (PCP) if another PCP in their area offered telehealth visits, among other findings.


American Well commissioned Harris Poll to conduct two surveys online in late 2016 to measure consumer perceptions and experiences with telehealth. Among those who have a PCP, 65 percent are interested in seeing their PCP over video. Parents with children under 18 are even more likely to say they're interested, with 74 percent interested in seeing their PCP through telehealth. Twenty percent of consumers are willing to switch to a PCP that does offer telemedicine visits.


"Consumers are interested in more convenient access to healthcare – and increasingly, they are even willing to switch providers to get internet video service. Not only that, but consumers are willing to try telehealth for many needs – from chronic conditions to post-discharge follow-up," said Mary Modahl, Chief Marketing Officer, American Well. "Health systems and provider groups must take note; if you haven't already, 2017 is the year to put a secure telehealth platform in place."


In addition to consumer interest in PCPs that offer telehealth, below are five fast facts from the survey report:

  1. Today, 50 million U.S. consumers would switch providers to one that offers telemedicine.

  2. Willingness to switch to a doctor that offers telehealth is highest among parents of children under age 18 and those aged 35-44

  3. Sixty percent of consumers who are willing to have an online telehealth visit would see a doctor online for help managing a chronic condition.

  4. Sixty-seven percent of adults ages 45-64 who are willing to have an online telehealth visit would see a doctor online for help managing a chronic condition.

  5. Seventy-nine percent of consumers currently caring for an ill or aging relative say a multi-way video telehealth service would be helpful.

The combination of these three studies all point to the benefits to all stakeholders of telehealth. Adding RPM codes that ensure doctors are compensated for their efforts will only increase participation.


Achieving the Triple Aim of Health Care

Recent studies on implemented RPM monitoring programs across the country are beginning to show evidence of its potential impact on the healthcare industry achieving its "triple aim." The triple aim is a term to conceptualize healthcare's three highest pursuits that are often challenging to accomplish in tandem: improving the experience of care, improving the health of populations, and lowering costs. Often though you must sacrifice one item to achieve the other two, this old triple aim stereotype is being put to the test by RPM monitoring programs.


Pete Ianace, SVP, Corporate Development

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