Telehealth picks up speed as providers see value despite challenges
KLAS partnered recently with the College of Healthcare Information Management Executives to ask more than 100 healthcare organizations about their plans for telehealth deployments.
Despite ongoing questions about reimbursement and regulation, virtual care platforms are finding favor for scheduled and patient-focused visits, on-demand and consumer-focused meetings and telespecialty consults, the groups found.
The benefits to patients have been worth the efforts to expand their reach, KLAS and CHIME said, even given the continuing uncertainty and financial challenges.
Cost, reimbursement levels, issues with the technology itself and its impact on the patient experience were among the concerns voiced by those providers surveyed. Nonetheless, most said they planned to either expand their telehealth programs to improve patients' access to care.
The report sees telehealth being used for three main purposes: patient-focused visits, enabling patients to schedule clinical meetings virtually; on-demand or consumer-focused purposes, to decrease the costs for patients and providers by dealing remotely with urgent or non-emergency care, and telespecialty consultations, connecting patient with specialists by video.
Patient convenience was one of the top drivers for telehealth, according to KLAS and CHIME – who noted that the success of the medium depends on patients having a high opinion of its value.
"Telehealth offers a great opportunity to enhance the lives of patients by making healthcare accessible to them wherever they may be," said Russell P. Branzell, CEO and president of CHIME. "Our members are advocates for improving patients' lives through innovations like telehealth. But it needs to be carefully implemented to meet its potential and we still face headwinds with reimbursement and integration issues."
Indeed, about half of those interviewed for the study said reimbursement was a challenge, with payers – whether private insurers, Medicare or Medicaid – often slow to reimburse virtual visits at rates comparable to face-to-face care. That often makes it hard for hospitals to make a compelling business case for telehealth, even if it's valuable for patients.
"Billing and reimbursement are factors that limit our ability to expand our telehealth program," said one director interviewed for the report. "There are things that we would like to expand to, but we just can’t get paid for them yet, so that is the major hurdle for us at the moment. In our state, we get reimbursed for the vast majority of telemedicine. We are getting reimbursed for about 90 percent of our telehealth visits. But there are some things that we would like to do that we can’t get the health plans to pay for and that the state doesn’t reimburse us for."
"The funding for telehealth, in general, is not where it needs to be," said another VP. "There is an out-of-pocket component, but if our most vulnerable populations who need telehealth don’t have the financial resources to pay for that care, they go without it. So telehealth services should be available for everyone. That is where the reimbursements need to come in."
Technology integration challenges were another big concern. Many respondents reported that integration between their electronic medical record and virtual care platform was "nonexistent or unidirectional," according to KLAS and CHIME.
"Telehealth holds enormous promise," said Adam Gale, president of KLAS. "However, the underlying technology needs to evolve faster. In particular, integration of telehealth with provider EMR's is still at a primitive level. Vendors need to step up in terms of technology and improved support."
Those challenges aside, telehealth's forward momentum seems to be continuing as more and more providers see the value it creates for their patients and for their own population health management strategies.
"We are going to provide a level of convenience for our patients that they want," said one healthcare executive. "Providing an opportunity for patients to receive care is what patients are going to appreciate. Another benefit is the care outcome for patients. Telehealth helps increase compliance rates for patients who are discharged and need follow-up appointments."