Thirty years ago, telemedicine was a narrow and niche practice, which nonetheless delivered a highly valuable service for patients in rural areas lacking nearby access to specialized care. Small clinics could transfer electrocardiograms, X-rays and other images to hospitals in urban areas for consultation. Over time, video links connecting patients directly to physicians became possible, although with limited application given the high cost of the videoconferencing equipment.
Today, telemedicine and the broader field of telehealth are showing the potential to change the way that care is delivered on a grander scale, from primary care to treating chronic diseases such as arthritis and hypertension. Smartphones are in some cases replacing the office visit. William Thornbury, a physician from rural Kentucky founded an application called meVisit, which allows patients to schedule an e-visit with their physician for routine medical issues.
Such “visits” are conducted through a phone call and/or electronic exchange of information between the patient and the physician or medical office. A year-long study of the service, conducted with University of Kentucky, found numerous benefits: an affordable $32-per-visit rate, an average response time of three minutes, and only 5 percent of e-visits requiring an in-person visit to complete the care. A remarkable 97 percent of patients who participated in the study were satisfied with the service; meanwhile, e-visits helped Thornbury increase his practice’s capacity by nearly 15 percent while reducing per capita costs at roughly the same percentage.
Telehealth solutions encompass a wide range of technologies including mobile apps, kiosks, video chat, wearables and other remote-monitoring devices. Benefits include preventing costly and unnecessary visits to the ER or urgent care facilities, reducing readmissions, assisting with patient adherence to treatment plans, and providing more convenient access to care for nonurgent conditions.
- A recent study by Towers Watson found that telehealth could save as much as $6 billion annually in U.S. healthcare costs. Of 420 midsize to large companies surveyed by the research firm, 37 percent said they plan to offer employees telehealth services as a low-cost alternative to face-to-face visits for non-emergency health issues.
- Another survey found that 90 percent of healthcare providers are expanding their telehealth
The Road Ahead
Still, as with any emerging technology, hurdles remain. Payers will need to universally accept telehealth visits for reimbursement, and compensate physicians comparably with in-person visits. Healthcare organizations and technology partners will need to work on simplifying process and workflow issues required to gain position acceptance, as well as addressing any potential emotional barriers for patients in replacing face-to-face visits with digital visits.
Perhaps most vexing of all, is quickly and cost-effectively solving the integration challenge. Still today, most remote-monitoring devices, mobile apps and diagnostic tools are not connected with core internal healthcare systems such as the EHR. These integrations are critical to eliminate the creation of an additional healthcare data silo, make optimal use of telehealth-driven data streams, and to further the goals of healthcare reform.
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