Overcoming Telehealth’s Perceived Complexities

According to Health IT Outcomes, Royal Philips and Arizona-based Banner Health have come together in a joint telehealth pilot program in an effort to address the shift “toward value-based care and increased penalties for readmissions.” As a result of the program, there has been a reduction of hospitalizations for chronically ill patients by 45 percent and savings within the first six months of the trial.

Dubbed the “Intensive Ambulatory Care (IAC)” pilot program, it focuses on what have been classified as the most complex and highest cost patients: The top 5 percent of patients who account for 50 percent of healthcare spend. The program was launched in 2013 and was designed to improve patient outcomes and care team efficiency, and prevent patients from entering the acute care environment where costs are significantly higher.

The program assessed the care of 135 patients to determine the program’s effectiveness in meeting its clinical and financial goals. “The results of our at-home telehealth pilot with Philips have been dramatic and are indicative of the exponential success such a program could have by engaging patients in their own care and building a strong support system around them,” said Dr. Hargobind Khurana, senior medical director of Health Management, Banner, in a statement. “As we continue to expand this program, we anticipate seeing further proof that telehealth programs can address readmissions rates, reduce costs, and improve the health and quality of life for patients with multiple chronic diseases.”

The pilot reduced costs of care by 27 percent, driven primarily by a reduction in hospitalization rates and days in the hospital, as well as a reduction in professional service and outpatient costs. It also reduced hospitalizations by 45 percent.

Prior to enrollment in the IAC program, there were 11.5 hospitalizations per 100 patients per month; after enrollment, the acute and long-term hospitalization rate dropped to 6.3 hospitalizations per 100 patients per month. The program reduced acute and long-term care costs by 32 percent, because of the decrease in hospitalizations.

“Telehealth is opening up choices for patients and providers, giving them the freedom to transform how, when and where proactive care is delivered to patients,” said Derek Smith, senior vice president, Hospital to Home, Philips. “By focusing on those patients who generate the greatest healthcare spend, we’re able to help these individuals get better care in the comfort of their own homes, while also helping health systems achieve the financial reductions they need.”

According to FierceHealthIT, in a somewhat dated but unsurprising report, the number of patients worldwide using telehealth services will rise from less than 350,000 two years ago to more than seven million in three years, according to IHS Technology.

With this move, which is likely conservative in its estimation, revenue for telehealth services will balloon from $440.6 million in 2013 to $4.5 billion in 2018. Mobile health hubs and projected growth in wearable technology as catalysts for such growth, the site reports.

“Amid rising expenses, an aging population and the increasing prevalence of chronic diseases, the healthcare industry must change the way it operates,” Roeen Roashan, a medical devices and digital health analyst at IHS, said in a statement. “Telehealth represents an attractive solution to these challenges, increasing the quality of care while reducing overall healthcare expenditures.”

In a newer survey, consumers are showing more interest in telemedicine than in the past, 75 percent of patients who have not used telemedicine are at least “moderately interested” in it, according to Software Advice.

With healthcare organizations looking to find more cost-effective ways to provide care–between 8 percent and 27 percent of ER visits are non-emergencies that could be treated in a doctor’s office or retail clinic — telemedicine provides an opportunity to ease the burden on ER staff and resources, the survey report points out.

As we know, telehealth reimbursement is growing, too, as legislation is now extending reimbursement to veterans and Medicare patients, with New York becoming the 22nd state to require parity in reimbursement for telehealth visits. According to FierceHealthIT, six other states — Arkansas, Connecticut, Indiana, New Jersey, Rhode Island and Washington — have introduced, according to the American Telemedicine Association.

Sixty-four percent of 2,019 consumers recently surveyed by Harris Poll on behalf of telehealth company American Well saying they are willing to consider a video chat with their doctor instead of an in-person visit. As we move further into comfort with the technology, better marketing of the products and education of the consumer space, telehealth will only grow as people look for better and easier ways to connect with their caregivers and telehealth efforts are likely going to be the key, even if the connection comes through a smartphone or a smart watch, for example.

The issue, however, for healthcare organizations may be one of adopting the technologies to serve these needs rather than waiting for a potential trend to come and go. With the overwhelming technology changes currently taking place, like health records and enormous other changes, telehealth may be regulated to the end of the line and over looked as a priority. However with some guidance, and a little help, hospitals can usually easily add capabilities for telehealth in relatively short order and likely ease. The biggest challenge may, in fact, be overcoming an overwhelming fear of the unknown when it comes to the movement.

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