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Telehealth in 2017: A CEO’s Predictions for HIMSS17 and Beyond

The top U.S. health systems are increasingly looking to telehealth to envelope their patients and extend their reach.
By Roy Schoenberg
09:30 AM
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Having been in the business of telehealth for 10 years, it’s remarkable to see the growth across the industry in just the last two to three – particularly among health systems. The top U.S. health systems are increasingly looking to telehealth to envelope their patients and extend their reach. In the last year alone, dozens of U.S. health systems rolled out telehealth for the first time– including NewYork-Presbyterian, Marshfield Clinic, St. Luke’s University Health Network, Covenant Healthcare, and Bon Secours. The era of provider-driven telehealth brings with it a new way of approaching telehealth. When done correctly, telehealth can support improved chronic condition management and overall population health, facilitate more immediate provider-to-provider consulting and referral management, make greater use of medical staff and facilities, and – importantly – create new business opportunities and enable providers to acquire more patients.

Given all this opportunity, it’s no surprise to see that telehealth is fast becoming a major focus of the HIMSS Annual Conference and a key business initiative for healthcare leaders in 2017. Following are a few predictions I have for how telehealth will evolve in 2017 – beginning at HIMSS17 – and based on my bird’s eye view of the industry.

Prediction 1: Telehealth will be reimbursed.

How doctors get paid for delivering telehealth is a critical component of whether they will continue to do it. Restrictions on reimbursement continue to be lifted as federal, state and commercial payers get behind telehealth as a way to increase overall access to care and make greater use of skilled healthcare workers. As of January 2017, the majority of commercial payers are reimbursing for telehealth. Because of this and broad industry support for greater reimbursement I predict that Medicare and other public payers will begin to soften restrictions and increase the amount and type of telehealth they’re willing to reimburse. Also, specialty doctors will look to telehealth as an opportunity to offer their services to consumers in traditionally unreachable markets – and will get paid directly by consumers out-of-pocket.

Prediction 2: In contrast to health plans, the ROI of telehealth for health systems will come from follow-up care, less so from urgent care.

Urgent-care telehealth is not going to “bring you the money,” and on its own is not a valuable telehealth strategy – especially for health systems. A hospitalist’s time is better spent on chronic and complicated cases versus a quick telehealth consult to give a patient suffering from allergies an RX for an anti-inflammatory. On the flip side – scheduled follow-up appointments to help manage a high-cost, complicated patient case (such as an elderly patient with diabetes) can help prevent avoidable hospital readmissions and improve medication management and adherence, in turn reducing the cost to the system while helping the patient achieve better outcomes. Telehealth is value-based care – when it’s used as a tool for population health management, and not a quick fix for the cold and flu.

Prediction 3: Provider workflows and EMR integration will become essential to physician adoption and subsequently the use of telehealth for follow-up care.

If a health system’s telehealth platform forces physicians to document virtual visits in a separate system from the EMR, doctors won’t do it. Telehealth platforms that aren’t seamlessly integrated into existing provider workflows, or force doctors to document in multiple places, won’t last. Emerging EMR-telehealth solutions that are being integrated into the provider workflow will become industry standard, not industry first. The good news is that when telehealth is integrated into existing provider workflows, it can be used for much, much more than urgent care – which leads me to my next prediction.

Prediction 4: Consumer telehealth services will expand beyond basic primary care.

Specialty care, occupational health and behavioral health (therapy, psychiatry) will take center stage as preferred telehealth services as more providers and patients recognize the benefits of making telehealth an integrated part of an ongoing treatment plan. If a follow-up appointment or pre-operative appointment can be done over video, in 30 minutes, from home, why do it any differently? Innovative providers will look critically at what they do best ‘offline’ in traditional care settings, or what conditions affect their largest patient populations, and begin to bring that ‘online’ through new telehealth services – such as pediatrics, cardiology, neurology and so on.

Prediction #5: Provider-to-provider telehealth will emerge as a key value driver for capitated health systems.

Under a capitation model, physicians are essentially given a set budget for managing patients. The focus for capitated health systems is on delivering preventive care and avoiding expensive treatment options. When a patient requires long-term care post-visit, health systems often work with skilled nursing facilities (SNFs) to arrange it. What complicates this arrangement is that the health system is still responsible for that patient, and may still need to intervene or provide additional follow-up care. This is where telehealth can be a huge assist – facilitating greater communications between the health system and SNF, and the patient, before a more costly health complication occurs. Telehealth essentially lets a health system follow the patient – wherever they go – making capitated and value-based models far more achievable.

I’m looking forward to seeing how these predictions take shape at HIMSS17 and in the months to follow but one thing is certain, without the crystal ball: telehealth is becoming provider-driven, and that’s great for doctors and their patients.

By: Roy Schoenberg, MD, MPH, CEO, American Well

Topics: 
Telehealth