Telehealth - Impacting Access, Cost and Quality / Blogs / Perficient

Where did 2014 go? It flew by…then again after I turned 30, I feel like every year is flying by. As this year comes to a close and planning begins for the upcoming year, like most organizations in the United States, my organization is going through an “open enrollment” period for healthcare benefits, allowing employees to make adjustments to their current healthcare benefits for next year. I rarely change my healthcare benefits. I usually just skim through the HR documents in the slim chance something major changed from the year prior. Ninety-nine percent of the time, nothing changes. However, to my surprise, this year, something maj or, and impressive, did change. For the first time, our healthcare benefits were going to include telemedicine. Amazing!

What is Telemedicine…or is it Telehealth?

Oftentimes we see “telehealth” interchangeably used with “telemedicine,” but there is a slight nuance between the two. According to Dr. Stephen Perkins, Vice president of Medical Affairs UMPC Health Plan, “Telehealth is a general term describing the delivery of health-related services and information by the use of telecommunication technology. It can include phone calls between physicians, videoconferencing or even robotic technology.” Telemedicine has a narrower definition: The specific use of medical information that is exchanged from one site to another via electronic communications for the health and education of a patient or a health care provider for the purpose of improving patient care. It includes consultative, diagnostic and treatment services¹.”

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The Impact of Telehealth

As the healthcare industry continues to go through major transformation, it is no surprise that healthcare providers are trying to find innovative ways, such as telemedicine, to deliver efficient and effective patient care. Through telehealth, providers can impact access, cost and quality to help achieve this.

Improve Accessibility – Telemedicine allows providers and patients to bridge the distance and time barriers that separate them. Rashid Bashshur does a fantastic job, describing the impact to access of care from both the provider and patient side²:

Providers²: Accessibility for providers in both remote and central sites relates to convenience, opportunity cost, and work load. Providers located in remote and isolated areas and institutions will have ready access to consultants and referral sources. With telemedicine, they may encounter less “red tape” in arranging for both consultations and referrals. Remote providers may be able to alleviate their work load and coverage during off-hours because of their link to medical centers and the use of non-physician providers. Providers located at tertiary care centers will be able to offer their expertise to a much larger and diverse provider and client population compared to those only seen at their medical centers.

Patients²: The target populations and the major beneficiaries of telemedicine are the geographically remote, the institutionally confined, and those otherwise medically underserved, including inner city residents and the elderly. The substitution of telemedicine for person to-person encounters reduces the need for travel and the related opportunity costs and other inconveniences encountered in the process of obtaining care. Instead of having to travel to distant tertiary care centers for specialized, and sometimes even routine, services, residents of rural areas, correctional institutions, and nursing homes could receive an array of services via telemedicine. Only when it is determined appropriate through consultation with specialists would it be necessary for clients to be referred or transferred to be served at the medical centers.

Patients don’t have to live in rural or remote areas to reap the benefits of access to care through telehealth. Access can also be related to sheer convenience. Many of us truly just don’t have time to get to the doctor. Penciling in a lunch-hour visit with our physician can prove challenging, especially when a can’t-miss conference call absorbs the bulk of our afternoon³. According to Jessica Harper, telemedicine eases this problem -through video, Web chat, or phone, workers can follow-up on a prescription or diagnosis with a physician and reduce the time you spend in the waiting room, flipping through yet another mind numbing magazine³.

Influence Costs – Telehealth reduces overall healthcare costs and can potentially generate an increase in revenue.

Contain Cost – The Center for Information Technology Leadership estimates that widespread use of telehealth systems to promote preventive care, early intervention and effective information sharing could save the United States $3.61 billion annually⁴. Telemedicine reduces travel expenses, especially for those living in rural communities, where they would need to normally travel hours out of their way to access key health services³. In addition, the number of days of work people take for routine visits can add up in lost wages. According to a recent study, with telemedicine, 92% of patients saved $32 in fuel costs; 84% saved $100 in wages; and 74% saved $75-$150 in family expenses⁵. Even more astonishing, $1.2 billion could be saved by video consultations between doctors and patients in cases where office visits are not practical⁵. In addition, many providers actual charge less for a telemedicine consultation than they do for a face-to-face visit.

Increase in Revenue- If time and distance barriers to care are removed, use of service is likely to increase, which in turn increases the volume without declining the cost and resulting in an increase in revenue generation². Improved operations can also prove to be a revenue generator. According to a recent study in Telemedicine and e-Health, hospitals that utilized telemedicine technology and referred patients to other hospital facilities, specifically children’s facilities, saw their revenue significantly increase⁶. The research looked at 16 hospitals’ billings before and after they implemented telemedicine tools. Before the implementation of telemedicine, the 16 hospitals recorded 143 transfer patients. After deployment the number jumped to 285, resulting in a revenue jump, going from $2.4 million beforehand to $4 million⁶.

Improve Quality-Enhancing quality of care, through more timely delivery care, care coordination and patient engagement is also an advantage to telemedicine.

Timeliness to Care – The National Healthcare Disparities Report (2009), states that, timely delivery of appropriate care has been shown to improve health care outcomes and delaying health care can lead to a diagnosis at a more advanced disease stage and reduce opportunities for optimal treatment⁵. The window to receive treatment for many disorders is typically small and early detection and diagnosis can be vital. Ongoing remote monitoring and the ability for patients to check in with providers via telemedicine, before something worse happens, makes a positive difference in patient outcomes and satisfaction⁷.

Care Coordination – According to Kevin J. Boyle, “Transition care typically includes both patient education and medication management components to help ease the transition from hospital to residential facilities and reduce readmissions. While face-to-face communication is ideal, it is often impractical. Telemedicine provides a quick, convenient and more affordable forum for assessing patient recovery, assisting with medication management and keeping patients on track with discharge instructions. Advanced high-definition video capabilities can also help clinicians’ document key indicators of recovery and conduct demonstrations for self-care or physical therapy techniques⁸“, especially those with chronic conditions.

Patient Engagement – Providers can involve their patients in their own healthcare, thus improving compliance and, over time, clinical outcomes. Randall S. Moore, MD, MBA, states that, “One of the most interesting and promising outcomes of telehealth programs has been the increase in patient participation and self-care. Because patients have an active role in their care plan and are in more frequent contact with their healthcare provider, they gain a better understanding of their condition and become more compliant in their care.⁹” Patients want to take a more active role in their healthcare and see technology, such as telehealth, as a mean to helping them achieve this important goal.

Telehealth has continued to grow as a unique way of delivering care to patients, while greatly improving access, reducing cost and positively impacting quality. The number of patients using telehealth services is expected to jump from the 350,000 in 2013 to about seven million by 2018¹⁰. Despite this staggering increase in users, there are still some barriers preventing its wide-spread use, such as resistance on the part of providers, limited insurance coverage and reimbursement, and privacy and security issues. However, over the past few years these challenges seem to be lessening as the healthcare industry, as a whole, is understanding the benefits of telehealth and from the looks of it, it seems like telehealth is here to stay as a recognized part of healthcare delivery.

What do you think? Do you think telehealth and telemedicine can change the healthcare industry?

Resources for this blog post:

Telehealth – Impacting Access, Cost and Quality

by Priyal Patel on January 5th, 2015 | ~ minute read

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