Virtual care can turn solving the access challenge from impossible to possible mission
Currently, the typical patient waits 29 days to see a physician, according to a recently released survey from Merritt Hawkins. And, it could get worse. The country is expected to experience a shortage of about 90,000 physicians by the year 2025, according to the American Academy of Medical Colleges.
As a result, patients are apt to seek primary care for minor ailments such as a cold of flu through emergency departments – or to simply go without any treatment whatsoever. Delivering care under such conditions could become virtually impossible.
“Access is a huge problem in American healthcare,” said Sylvan Waller, MD, a physician executive. Waller served as one of the catalysts during The Health Innovation Think Tank: A Collaboration of Global Health Industry Thought Leaders, an event that was co-hosted by Lenovo Health, Justin Barnes Advisors, University of Pittsburgh Medical Center/Critical Care Medicine , Inventiv Health and HIMSS Media.
The good news is that virtual care could solve this access dilemma. Indeed, remote monitoring, secure communication and telehealth solutions can connect doctors to patients directly while also addressing healthcare’s triple aim and reducing the need to seek care in inappropriate, high-cost settings.
“When all of these virtual technologies are leveraged, a virtual connected health eco-system is created. Consumers can then engage with providers through these virtual systems – and the home becomes the primary care setting. Technologies such as the Alexa app, with applied health skills, becomes every consumer’s trusted health assistant,” said Tom Foley, director, global health solution strategy at Lenovo Health.
The big question: Are healthcare organizations ready to migrate to virtual care delivery? “The technology is there. Consumerism is there. People expect services on demand and they want concierge care,” Waller said. “It is coming. However, [virtual care] is just not quite there yet as barriers to adopting it are much harder than we thought about.”
Steve Aylward, senior vice president of partner enablement at Change Healthcare, agreed. He explained how he sees both strong demand and challenges on the horizon for virtual health.
“Reader’s Digest recently ran an article telling its readers that they have to have three popular telehealth apps. So, when Reader’s Digest starts telling its readers they need something, it is definitely becoming mainstream,” he said.
To optimize virtual health’s potential, however, organizations need to overcome a variety of challenges associated with: Regulatory and legal requirements. “In the U.S., prescribing regulations are huge,” Waller said. Many states limit clinicians to providing treatment only to patients who are located in the state where the caregiver is licensed to practice. In addition, clinicians need to establish patient doctor-patient relationships, assess the patient and come up with a treatment plan.
Consumers, however, should not be restricted by such constraints, according to Foley.. “This is where we lose patient engagement,” he said. “We should have the choice and the option to work with doctors in other states to get advice. This state barrier should not be an inhibitor. The legislative policies that restrict this need to change.”
Trust in virtual health services. “Consumers don’t know the difference between telehealth providers. There is no brand recognition,” Waller said. “When a health system lends their brand, however, those patients have much more trust and adoption is much better.”
Understanding payment rules. According to Jeff Coughlin, senior director of federal and state affairs at HIMSS, Medicare beneficiaries may receive telehealth services in a variety of settings. Current Medicare law (SSA Section 1834(m)), however, restricts telehealth payments by the type of services provided; the geographic location where the services are delivered; the type of institution delivering the services; and the type of health provider.
The good news is that payment concerns are becoming less onerous. Indeed, a 2016 Consumer Telehealth Benchmark Survey where just 34 percent of respondents cited reimbursement as an adoption barrier, compared to 72 percent in 2015.
Recognizing the sweet spot. Organizations are beginning to realize that virtual care needs to expand to be financially feasible. “Everyone in the 1.0 version of virtual care is realizing that just treating cough, cold, congestion is a losing business model,” Waller said. “So, as they move to the 2.0 version, they are realizing that they need to get into chronic care management.”