Underserved communities in the U.S. stand to benefit greatly from telehealth and mobile health technologies, but only if clinicians adjust their workflows to include remote care, payers start offering the right financial incentives for providers to do so and the technology infrastructure is in place to support digital outreach, attendees at a conference heard last week.
“It all boils down to workflow,” Jeff Russell, director of vertical market sales for online videoconferencing technology company Vidyo, said at the Health Technology Forum Innovation Conference Friday in San Francisco.
“It’s never the technology that’s the barrier. It’s the workflow,” agreed Dr. Yan Chow, director of Kaiser Permanente’s Innovation and Advanced Technology Group.
One reason why workflows do not support telehealth is because payers traditionally do not reimburse for such services, Chow noted. “For many specialties, they’re still thinking traditional care. That’s how they’re paid,” he said.
That is changing, however. Tapan Mehta, global healthcare lead for Cisco Systems, reported seeing a “significant picking up” in telehealth usage in the last 12-18 months, in no small part because of the wider availability of reimbursements.
The new Medicare policy of not reimbursing hospitals for preventable hospital readmissions within 30 days of discharge of patients with heart attacks, congestive heart failure and pneumonia, as part of the gradual shift in general toward bundled payments, also has prompted some providers to invest in telehealth services, panelists noted.
The growing national primary care physician shortage is another concern, one that likely will worsen in the near term as millions of currently uninsured Americans gain coverage under the Patient Protection and Affordable Care Act starting next year. Telehealth and mobile health certainly can help, but providers and vendors alike still are looking for the most appropriate use cases and grappling with reimbursement issues as they innovate.
“Teledermatology is a winner. Telemental health is a winner. Telestroke is a winner because of the urgency in caring for stroke patients as quickly as possible,” Chow said. Telehealth also is helpful for monitoring patients with congestive heart failure at home, according to Chow, but beyond these areas, the benefits remain unclear.
One problem: Home and even in-hospital monitoring devices turn out a lot of data, and IT systems and clinician habits usually are not set up to process the additional information. “Physicians already have too much data,” Chow said. Keep reading>>