Telehealth Global Phenomenon Redefining Healthcare
Now legal in every state, telehealth redefines healthcare in a more comfortable and convenient setting. The market opportunity is substantial, both nationally and abroad.
“It’s not just a U.S. phenomenon; it’s a global phenomenon, and a lot of the world is looking to the U.S. for guidance, for second opinions [and] for technology,” said Jeff Kosowsky, MD, PhD, American Well senior vice president of corporate development, during an executive roundtable at the Becker’s Hospital Review 8th Annual Meeting, on April 19 in Chicago.
Dr. Kosowsky told 23 participating hospital executives that “care is coming home,” and telehealth is central to this healthcare industry transformation.
“We’re now in a world where healthcare is last. People are doing banking online [and] buying everything online,” Dr. Kosowsky said, noting consumers and providers are increasingly ready to jump on board with online healthcare.
More than two-thirds of Americans are willing to see a physician online and 57 percent of physicians are willing to see a patient over video, said Dr. Kosowsky. Additionally, 25 percent of patients reported they would switch to a new physician for video visit access. Dr. Kosowsky emphasized telehealth should not be viewed as bringing patients to physicians, but rather assisting physicians in treating their patients remotely.
Founded a decade ago, American Well strives to do just that, offering a technological platform accessible via mobile, online or phone. The telehealth company serves all segments of healthcare, including health plans, employers, health systems, pharmaceutical and retail.
There are two distinct segments:
• Supply — Health systems and provider groups who provide clinical knowledge.
• Demand — Employers, health plans and their consumers who seek care
“You really need a complete end-to-end system,” said Dr. Kosowsky, suggesting providers should think of telehealth as more than just software. Instead, telehealth is analogous to a multispecialty medical office building, in which providers share resources and expertise.
When Dr. Kosowsky spoke about bringing care home, he emphasized this transition doesn’t illustrate the shift from a physical hospital to a web-based portal. Rather, it propels the idea of care going to the patient as opposed to the patient traveling to the care.
Further, telehealth is expanding beyond just urgent care into chronic disease management and prevention medicine. “Most of the time we’re not spending in the hospital…our disease processes are going on all the time, and that’s really where we need to interface with it,” said Dr. Kosowsky.
Telehealth has certainly not reached its full potential, due to a variety of obstacles in the industry. Reimbursements continue to serve as the main barrier to telehealth implementation, more so than the technology itself.
“Reimbursement is a very powerful incentive for physicians,” said Dr. Kosowsky. “When providers finally can make money, I think that’s going to be a huge motivator.”
The president of a Midwest children’s rehabilitation hospital agreed with Dr. Kosowsky’s statement, noting the financial aspect of telehealth presents a significant downside for his hospital, as physicians put in more work and are not fairly compensated for their additional efforts.
“There are limits to what you can charge and it’s nothing in comparison to the hours the physician needs,” he said.
Dr. Kosowsky noted organizations should employ the right incentives to encourage provider and patient support for the technology. Providers should view telehealth as leveraging technology to help patients manage their care between visits.
Not yet meeting the needs of all stakeholders, vendors continue to tweak the telehealth service to better align incentives. The medical director of a North East health plan covering 450,000 members added, the incentive of telehealth already exists, as consumers increasingly seek convenience in their care.
“But the more convenient you make [telehealth], the utilization sometimes goes up,” he explained. “From the physician standpoint, it’s a two-edge sword; you want to be available, but you can’t be too available.” He predicted tremendous demand for telehealth if healthcare organizations align incentives and overcome the financial and operational barriers.
Dr. Kosowsky said telehealth should ideally provide another avenue of support, but not become the sole access point. This requires a balancing act to prevent patient overuse, as it would result in strained clinicians.
“I think [telehealth] is another tool in the toolbox for providers; it may not be the only one,” agreed a CEO of a 67-bed Midwest hospital.
The healthcare business environment is evolving, allowing greater freedom for stakeholders to collaborate on building a whole delivery system.
“We think the marketplace idea is not just about buying and selling individual physician services, it’s about established healthcare organizations buying and selling branded clinical services” concluded Dr. Kosowsky. “I don’t think of telehealth as being a technology. I think of it as being a solution for bringing care home, which happens to be driven by technology.”