Hospital culture is shifting toward telehealth, experts say at ATA

While reimbursement is largely seen as a roadblock, a number of bold companies are forging ahead now rather than waiting for payment issues to be settled.
By Laura Lovett
03:27 PM

As hospitals struggle to keep up with growing needs of an aging population, many are at least looking at how virtual healthcare can save time, cut costs, and lead to patient-driven outcomes.

At the American Telemedicine Association Conference in Chicago earlier this week, industry players sat down to talk emerging trends in virtual care and where they see it in the future.

“Telemedicine is the wrong name. It's an antiquated name. It describes what we do as the same thing we do today, but at a distance; a one-on-one interaction at a distance,” Kaveh Safavi, MD, senior managing director and head of Global Health Practice Accenture, said at the conference. “I have stopped using telemedicine as terminology. I think about a concept of virtual healthcare as one that encompasses a variety of digital technologies, some that allow a consultation at a distance, some that allow self-service, smart self-service, patients providing for each other in a community to find a social platform — basically any form of technology that allows care to be delivered without requiring the physical proximity between a doctor and a caregiver.”

Here comes the Silver Tsunami, where there will be fewer caregivers to provide for a growing number of patients.

Safavi pointed out that a behavioral health platform could be used to help therapists treat more patients.

“In [the] U.K., 65 percent of all patients who are getting behavioral health therapy with a therapist are seeing a therapist that [is] using Silver Cloud, that came out of Ireland. It basically provides cognitive behavioral therapy to support the therapist,” Safavi said. “They have peer-reviewed literature that shows the therapist can take care of six times as many patients with that technology than without.”

While industry insiders are excited about how telemedicine and virtual medicine could help impact the system, there is still the reimbursement hurdle, which has been a notorious struggle for telemedicine.

But some experts are saying not to wait around for payers to figure out the reimbursement.

“Instead, look for opportunities. There are other [players] in this marketplace that are not waiting for permission, they are not waiting for reimbursement,” Jodi Hubler, managing director at Lemhi Ventures said. “They are figuring out ways to bring in new ways that will have people practicing at their highest licensure level without waiting.”

Virtual healthcare, however, has left payers and providers struggling to figure out what a payment model would look like for this service. Typically a patient sees a provider and the provider is reimbursed in the classic fee-for-service model. But in the future virtual health could shake that idea up.

“We don’t have any effective way of transferring money without physician activities going on,” Safavi said. “What we really want to do is change the mindset from paying for activity, to some form of payment that allows us to reward non-consumption of resources.”

While the industry continues to evolve, new players like Walmart are jumping in the healthcare field, which could also disrupt the status quo.

These entries, not to mention Amazon, Apple, IBM, Google and Microsoft, could propel the traditional providers to change the way they offer care to become more consumer friendly and, incidentally, more tech-friendly.

“A place like Walmart has this [large] geographical footprint. For me I always made this distinction there are two types of personas that live in a person: a consumer persona, that is making decision about how they access care and they are thinking about health insurance, they are thinking about a primary care doctor and the way they want to receive care,” David Smith, founder of Third Horizon Strategies said. “Then there is the patient who is in the thick of receiving care and they have to make more complex decisions with their physicians …What I think Walmart and CVS are doing is they are trying to create an aligned sense of how to control and have some impact over that access piece.”

While no one denied that relationships with clinicians are important, so is convenience.

“I think what we don’t understand and what these new entrants do is that when a person wakes up in the morning and doesn’t feel well, what they really want is to understand what their problem is and to figure out how to treat it — not to see a doctor. However, the provider view is what they want is to see a doctor,” Safavi said.

But healthcare can learn from other industries about evolving with technology, according to Hubler. She noted that when Netflix came into the video industry people didn’t know what would happen to actors. At that point, reality TV was on the rise and many were saying it was the death of the acting profession. But Netflix not only innovated a better way to watch shows, she said, it produced new content and gave opportunities to actors.

While there are still a lot of questions about what virtual healthcare in the future will look like, there is no question that virtual care will eventually arrive.

“The culture is slowly starting to shift in favor of digital and in favor of technology,” Smith said.

Twitter: @lauralovett7
Email the writer: laura.lovett@himssmedia.com

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