EVERYONE IS DOING TELEHEALTH. HERE’S WHY! Raymond Rupert MD. MBA. RUPERT CASE MANAGEMENT Inc.

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Tele-health has been around for a long time. In the 1950’s the first doctor-patient tele-health intervention occurred. To accomplish this, two TV studios had to be built for the doctor and for the patient at the cost of millions of dollars.  Things have changed.  Today, two $30 webcams will do the job.

I just attended the Mobile Health and Tele-Health meeting in Boston, organized by the World Congress.  Many big health systems attended. They discussed what they were doing in the mobile and tele-health space.

Here are some key learnings from the presenters:

Ed Marx of the Texas Health System focused on developing sustainable business models for tele-health.  The model , according to Ed, is economically sustainable with a reduction in readmission rates of 30%.

Ed suggests that tele-health is at a tipping point.  About 90% of patients want access to health information, to scheduling and to prescription refills.  83% want access to their own health records.

Ed said that when planning tele-health services that work flows and usability must be factored in or the services will fail.

Joe Cafazzo, Lead at the Centre for Global eHealth Innovation at University Health Network in Toronto focused on tele-health and chronic disease. These patients represent 85% of total health spending. For example, dialysis at home can be very cost effective for the healthcare system.

Lou Silverman, Chairman and Chief Executive Officer of Advanced ICU Care spoken about his company’s growth in the remote staffing of hospital ICU units. Lou’s company brings hard to find intensivists to smaller hospitals.

Silverman noted that remote ICU monitoring brings better outcomes, increased compliance with best practices and a higher return on investment for his hospital customers.

There is a focus on best practices, true 24X7 intensivist service, Leapfrog compliance and the use of predictive algorithms.

According to Silverman, the improved outcomes have a reduction in mortality of 30%,  a drop in length of stay by 20 to 30%, decreased ventilator days and decreased ICU readmissions.

Robert D. Egan, Chief Marketing Officer, Healthagen, an Aetna Company discussed how Aetna has partnered with a number of companies in mobile and tele-health services in order to provide additional value to their customers.

Venky Kulkarni, Chief Information Officer, Vice President, Digital Health, Medavie Blue Cross described how Medavie Blue Cross is increasing the role of tele-health services including the tele-pharmacy business to serve hospital customers.

Julie Hall Barrow, EdD, Senior Director, Healthcare Innovation Telemedicine, Dallas Children’s Medical Center described how to re-allocate resources in order to improve the health eco-system. There is a need to keep her pediatric patients out of the ER. The success comes from integrated teams with shared records.   Julie stratifies the kids into groups based on complexity. The complex care kids have more than 3 subspecialists.  She uses care management registries which impact and improve the continuum of care.  Dallas Children’s has a sustainable tele-health service. She has integrated her tele-health service with local schools and churches.

John Schmucker, MBA, Program Lead, Virtual Practice Project, Partners HealthCare  has focused on virtual visits. He asserted that 3 of 5 visits can be virtual with chronic disease patients. A clinical trial showed that there were no differences in diagnosis or care plan with asynchronous virtual visits.

Other speakers described specialized tele-health programs that their organizations were providing including: tele-dermatology, tele-psychiatry, tele-stroke, tele- addiction, tele-pediatrics, tele-dentistry, tele-retina and remote patient monitoring.

Some health systems have patients located many hours away. Tele-health is the only logical way to expand and simplify their services. Patients are totally committed to this approach if they can save a 2 hour drive each way for a 10 minute doctor’s visit.

Hugh Hayle heads up the tele-health network of the Visiting Nurses Of New York (VNSNY). This group is a $2B per year not for profit with a home based focus.  VNSNY does 35,000 home visits per day in New York. This is a logistical challenge. Their integrated care model is mission centric and nurse lead. VNSNY will risk stratify patients by collecting and analyzing data. They use predictive analytics. Hayle’s objective is to overhaul the infrastructure at VNSNY in order to cope with the demand for home based care.

Neil C. Evans, MD, Co-Director, Connected Health, Office of Information and Analytics
Veterans Health Administration, U.S. Department of Veteran Affairs stated that through connected health the VA was engaging patients. Their patient portal has 25,000,000 users. It promotes self management.

As you can see from the World Congress meeting in Boston, everyone is doing tele-health and for good reason.