Innovation in telemedicine technology: An entrepreneur's perspective
The need to provide high-quality healthcare to everyone while reducing costs has reached a crisis level, where it's a major focus of the highest government offices. More and more politicians and healthcare leaders are realizing that telemedicine is clearly a cornerstone of the solution. This is tangibly seen by the increasing number of healthcare systems that are adopting telemedicine, by the growth of ATA and by industry investments in telemedicine products and services.
I believe that telemedicine is now reaching an “inflection point,” where the industry will grow at an exponential pace. We are realizing that if one can bring the right clinical expertise to the right place at the right time to make the right medical decision in a cost effective manner; quality can be improved while costs are lowered.
Although the concept of telemedicine is simple and elegant, implementing it can be complex and messy. This is not unexpected, as fundamental change in any industry is never easy and without obstacles. As one works to implement telemedicine in order to benefit from this enabling technology, one quickly uncovers the many challenges in actually building telemedicine programs. Barriers created by existing payment structures, regulatory policies, IT architectures, corporate boundaries, resistance to change and technology limitations all need to be overcome. It is these barriers or challenges, coupled with the significant potential value that can be created, that make telemedicine ripe for innovators and entrepreneurs.
I believe that through persistent innovation, usually accompanied with the risk of capital, entrepreneurs can overcome these barriers and unleash the benefits of telemedicine into our healthcare delivery system.
To succeed in creating positive change I believe in the “divide and conquer” theory. Trying to orchestrate a singular fundamental change to our healthcare delivery system to incorporate telemedicine systemically is too monumental a task, and will likely fail. The pathway for entrepreneurs to innovate successfully is to find appropriately sized healthcare workflow challenges that can benefit from telemedicine solutions, and then work to gain adoption from healthcare providers. With adoption, the entrepreneur can continue to build on that success and expand the vision and market opportunity.
As the telemedicine industry grows, applications are partitioned into two broad categories differentiated by the health status and location of the patient. The first category is “acute care telemedicine,” in which telemedicine is used to enable remote clinicians to immediately diagnose and treat sick patients. These patients may be very sick and require immediate help from a specialist who is difficult to access. The second category is “chronic disease management telemedicine,” where telemedicine is used to periodically and regularly monitor and manage a person’s chronic illness.
The needs of the telemedicine solution and the economic model vary greatly across these two categories. Telemedicine solutions for acute care must enable a remote clinician to be interactively present in the patient environment and gather pertinent medical information through examination and data access to form a medical decision. Often, this decision can have significant (e.g. life or death) consequences. If the remote clinician is the physician-in-charge, then the system must enable the physician to lead and establish dominion over the complete environment. Conversely, telemedicine for chronic disease management generally does not require acute medical decision-making, and the interactions are more coaching and mentoring in nature. These solutions often connect healthcare providers into patient’s homes and therefore must scale cost effectively to a single patient/single system mode.
Telemedicine entrepreneurs should identify opportunities where they can innovate manageable-sized solutions that create significant value for healthcare providers. Still, change is always difficult, particularly in the field of medicine, where process and procedures are honed and perfected over decades to ensure that every patient receives consistently high quality care. Therefore, the solution must solve the problem in its entirety for adoption to occur. For example, solutions should not be limited to technology alone, but rather, they need to be coupled with clinical protocols, business plans, training and implementation services, regulatory assistance and even the ongoing monitoring and measuring of the solution's impact. The level of multi-disciplinary depth and detail required to facilitate a change can tax even the most persistent entrepreneurs.
Healthcare is in a seismic state of transition that hasn’t been seen for many decades. The fundamental goal of changing from “fee for service” to “fee for value” and competitive pressures re-aligned to drive continued improvement of the quality/cost value curve is enabling telemedicine to transition from a research topic to mainstream medicine. Generational changes like these happen infrequently, and should be embraced by adventurous entrepreneurs. We are at a time when the need for innovation and entrepreneurism in telemedicine is at a maximum.
Yulun Wang is chairman and CEO of InTouch Health.