Telehealth stands among the healthcare industry's few technology success stories. It brings virtual care to underserved or remote locations. It gives facilities an opportunity to export expertise or, conversely, outsource costly operations. It cuts costs for healthcare systems as well as patients.
For many in healthcare, though, telehealth remains a hard sell. It's an innovation in an industry that's not used to disruption. It requires technology infrastructure upgrades that carry a hefty price tag or, in the case of broadband, rely on federal action. It disrupts workflows. It raises questions about licensing and reimbursement that are hard to answer amid changing business models.
To that end, last month's mHealth and Telehealth World Congress attempted to bring some clarity to the challenge of selling telehealth.
Telehealth Buy-in All About Time, Money and Technology
Panelists in one conference session named three operational elements necessary for securing telehealth buy-in: Time, money and technology. If it takes too long, costs too much and seems too complex, it won't work.
That's where telehealth's strategic amplifiers come into play. These are many and varied – expanding access for rural patients and providers, aligning with an academic mission or business strategy, increasing referrals and, of course, introducing new revenue streams. Highlighting these gains will help offset concerns (real or otherwise) about time, money and technology.
At the University of Mississippi Medical Center, the telehealth program began in the early 2000s in response to delays in rural care observed in emergency and traumas transfers to the facility – the lone academic trauma center in the state. The program now covers 34 specialties and connects the state's hospitals to clinics, offices, schools and even homes, says Kristi Henderson, the medical center's chief advanced practice officer and director of telehealth.
Henderson says success depends in part on explaining telehealth's value proposition in meaningful terms to program leaders. Come to the table with a clear understanding of what you intend to monitor and evaluate as the program progresses, she says – length of stay, for example, or readmission rate.
It pays to know where key stakeholders reside, says Peter Kung, director of strategic technologies for the UCLA Health System, where the UCLA Innovates HealthCare Initiative looks for ways that technology can improve access to care. Frame the telehealth discussion in terms of benefits for the system at large as well as for individual staff members. Make sure the ROI will be realized within three years or will affect at least 20 percent of a patient population, he adds.
[ Feature: Why Telemedicine Is Finally Ready to Take Off ]
The operational element of telehealth indeed matters, but it need not be complex. Start with the basics of videoconferencing, Henderson says, and refine the program later. "Don't paralyze yourself by trying to make it perfect."
In addition, there's the "swag" element, says Dr. Sarah N. Pletcher, medical director of the Dartmouth-Hitchcock Medical Center's telehealth center, which was founded in 2012 to provide acute care telehealth, ambulatory efficiency and collaboration services. Giving doctors new iPads and webcams in conjunction with telehealth initiatives will boost enthusiasm for the program, she says.
Practical, Regulatory Barriers to Telehealth Adoption Continue to Fall
As noted, no discussion of telehealth is complete without mentioning both telehealth licensure and reimbursement. These remain state issues – and few regulations remain consistent when crossing state lines. This stifles the spread of services from neighboring communities and means that no national standard has been set for patient safety guidelines.
The momentum is shifting, though. More than 100 bills before state legislatures aim to hasten telehealth adoption and break down licensing and reimbursement barriers. In addition, the American Medical Association gave telehealth a hearty endorsement during its most recent annual meeting.
Today, telehealth still progresses primarily in the form of pilots. Some patients and providers are an easy sell, free iPads or no, but others need prompting. For insight into telehealth's proof of value, study the physicians who use it, says Dr. Ronald F. Dixon, director of the Delivery Innovation Program at the Center for Integration of Medicine and Innovative Technology. This will help you demonstrate whether the technology "intervention" actually makes physicians' lives easier and adjust your strategy accordingly, he says.
As the value proposition emerges, and as the regulatory environment continues to sort itself out, external barriers to telehealth adoption seem to be falling. That leaves internal barriers. Increasingly, then, the only thing standing in the way of a healthcare organization using telehealth is the organization itself.