Virtual Care Takeaways from ATA 2019 Annual Conference and Expo
The American Telemedicine Association held its 2019 Annual Conference and Expo from April 14-16, 2019 in New Orleans, and InTouch staff members were in attendance to tap into the latest news and information regarding the telehealth industry. Our staff shares some of the most valuable takeaways from the ATA 2019 Annual Conference and Expo:
Tech Giants Targeting Digital Telehealth
Nate Gladwell, MHA, RN Clinical Operations Officer at the University of Utah discussed successful health system motives in direct-to-consumer (DTC) applications, beginning with the fact that tech giants like Amazon, Apple, and Google are targeting telehealth – but why? These giants aren’t interested in telehealth because it’s digital. They are targeting digital because of scalability – digital means you can go almost anywhere you want to go. It’s easier to go digital than it is to set up an operating room, for example.
Technology companies are already structured to help consumers by targeting their searches, and they want to get to where the consumers are – which isn’t in the operating room. Anyone in an operating room is there because they have to be, not because they want to be. They are interested in consumers, scalability, and the job that is to be done. For those driving a strategy in digital health, this is a critical idea that must be understood.
Delighting the Patient
One of the top barriers preventing widespread adoption of telehealth is a lack of coverage by insurers However, discounting the benefits of a telehealth program simply because insurers won’t pay for the services represents a faulty way of thinking about DTC virtual care. DTC business needs to be thought of differently; it must, first and foremost, delight patients.
University of Utah was one of the first health systems to put physician reviews online, and many other systems followed suit. Providing consumers with the transparency to recognize the value and quality of care they will be receiving from a given healthcare professional is one step towards delighting a customer and achieving a successful DTC telehealth program.
In order for services to be considered “of value” to consumers, they must be high in quality and low in cost. DTC practices have a cost per unit that is substantially lower in a recent RAND study. For example, once a health system began to utilize DTC for diabetes management, pharmacy costs significantly decreased. When systems look at the total cost of care, a slight increase in utilization shouldn’t be a concern in its lowest cost environment, which is a digital environment. Meeting the job that needs to be done and delighting patients is what should be the main focus. When systems meet and delight consumers while getting the job done that needs to be done, they will beat the healthcare giants and earn customer loyalty along the way.
Global Health Trail Blazers – Experiences, Lessons, and Key Considerations
Sharon Allen, Executive Director of World Telehealth Initiative explained that the organization has begun to bring medical expertise to impoverished communities around the world who are lacking. One of the many benefits of using telehealth capabilities for this project is that it creates a link so doctors can continue to support the low-resourced areas after they return from their initial visit overseas.
There are some hurdles present: Considerations must be taken to see how much of the culture should be taken into account in building the program. Seeing what common points exist between cultures is interesting; what is different among cultures can also be identified. Trans-international telemedicine is starting with a problem, however: because they don’t see the differences, they also do not see the commonalities they share. Additionally it’s a challenge to work with several time zones and languages, as is utilizing U.S. physicians who volunteer their time to provide their services around the world. Exporting equipment to various countries is difficult, but collaborations with Direct Relief allow for sufficient access to medical supplies. Some countries have to get approval for what is the equivalent of FDA equipment.
Transforming Care with Telemedicine
Denise Pimintel of Dignity Health spoke on transformation, citing that one day, we all want remote care and local care to be indistinguishable. Technology should become almost invisible to people; we want it to work almost 100% of the time in the background.
It’s also crucial to put the right person out front as a remote provider because motivation is an important part of virtual care. The remote physician must be someone who wants to provide virtual care, and they must have humility, be able to build trust, and be very situationally aware of how they come across to local providers.
To kick off a telehealth program, weekly meetings with partners and remote care teams is crucial. You want the partners to know that the remote providers really want to be a member of the team. Whenever you’re talking about a remote presence, you are talking about a relationship and communication barrier that you have to overcome. Ongoing relationship building is critical, and the more face time they get with the staff, the better the relationship is going to be.
Pimintel states, “As a network, we really work hard at keeping leadership engaged. We want to keep them informed and up to date with what’s happening on the ground. We put forward our success and challenges. We are keeping patients in-house, we are keeping these patients close to their families and close to the resources that matter most to these patients.”
Impact of Telecare Technology on the Healthcare Workforce
Karen Deli of InTouch Health spoke on the impact of telecare technology on the workforce and analyzed current healthcare patterns. Regarding supply modeling, burnout, early retirement, and the like, what if the healthcare delivery system takes us in one direction or the other? The potential for telemedicine to keep physicians in the workforce longer and enjoy their careers more is a good measurement of supply. Included in the access to demand is access to care. A cautious estimate states that burnout could cause a shortage of 42,000 physicians by the end of 2030; high estimates put that number at 120,000. As technology advances, physicians might be able to do more, easier, and with less burnout. Telemedicine may have the potential to break down financial and geographic barriers to care, but unfortunately, reimbursement levels are still low in many areas.
Establishing Telehealth Networks
Regarding telemedicine, Karen Deli of InTouch Health stated, “I have watched the space evolve from its own thing on the side to being integrated into all specialties and as a standard way to provide care.” She further explained that there is a social aspect of practicing medicine; hospitals are social environments, but telemedicine is not. It’s also political in the hospital; establishing the environment with collaboration is critical to telehealth integration success. Facilities must be on virtual journal clubs and have the ability to have instantaneous chats that are HIPPA-compliant, and they must also regularly engage in seminars, working to establish their own networks.
In addition, having physicians from all over the country come together as one team builds comradery. It takes their practice to the next level with a structure in place. Deli explains, “It is important that there is a definition of what excellence is. Telemedicine is a communication tool, and it’s a communication style.”
There must be training and education on how to interact with patients. To assume it’s the same over video would be a mistake. Training for remote providers is crucial. We talk about the people on the provider end, but we need to discuss the people who are coordinating, making sure patients can receive care.
InTouch Health has created tele-presenter courses, and it’s critical that hospitals have a similar set of expectations to have training on what they will need. This holds true for both the local and remote sides. Clinicians also need to be a part of the research and discovery; these things must still enable physicians to be able to deliver quality care.