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Is this the year?

Telehealth at a Tipping-Point. Is this the year?. Mary DeVany Associate Director, gpTRAC.

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Is this the year?

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  1. Telehealth at a Tipping-Point Is this the year? Mary DeVany Associate Director, gpTRAC This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number G22RH30357-01-00 under the Telehealth Resource Center Grant Program for $325,000. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

  2. Tipping point? Really? Again?

  3. We would prefer...

  4. Slowly...steadily...

  5. We have been talking about this for years!

  6. Four Domains of Telehealth • Hospital & Specialty Care • Specialists see and manage patients remotely • Integrated Primary Care • Specialists (MH, nutrition, etc.) integrate services with primary care • Remote Monitoring for Transitions and Maintenance • Physiological and behavioral monitoring to maintain best function in least restrictive, least expensive, or most preferred environment • Direct to Consumer Services (Primary/Urgent Care) • Convenient access to needed/desired services; popular among younger, busier, and generally healthier patients

  7. There are still hurdles...

  8. Challenges include: • Uncertain reimbursement • Legal and regulatory difficulties • Organizational buy-in and integration • Low provider acceptance and adoption • EX: 89% of emergency medicine physicians indicated they would use telehealth, but only 11% actually have • Access to adequate and stable broadband • Understanding the changing environment

  9. Because of this, we need to be creative… • Reimbursement • Bundled services? • Contracted services? • Legal and regulatory • CMS working around the “originating site” issue • States are working to look at things differently • Organizational buy-in and integration • New partners, in order to address problems differently (SUD) • Schools (k-12; colleges) • Community-based employers

  10. The target keeps changing...

  11. A shifting in what’s deemed “important”? Just what is the “return on investment” for (tele)health? • Number of visits and the related reimbursement amounts? (actual revenue) • Reducing the overall cost of a patient’s care in the long run? • From the organization’s/provider’s perspective? • From the patient’s perspective? • Improving the overall quality of the care received/provided? • Understanding the impact to a patient’s or a provider’s quality of life? • Are there other value points to consider??

  12. Also, changing? The ones calling the shots...

  13. What we are seeing... • Enterprise-wide approaches • Less siloed telehealth services • Fewer stand-alone vendors or providers • More integration with routine care processes • Looking for impact across the organization • Expectation for interoperability across technology platforms • Cross-Connectivity • Easily access, share, collect patient information • Compatibility with EHRs

  14. What we are seeing... • Primary care opportunities • Integrated care and services - in the clinic (rural/urban) • Support patients as they better engage in their own care - at home • Improved opportunities for the safety-net providers • Patient/Consumer in the driver seat • Better/Improved access options • Patient determines best option for their use • Businesses/Employers are more actively engaged

  15. It’s not just for “specialty services” • Primary Care is seeing a great deal of activity • Primary Care • Urgent Care • Behavioral Health • Chronic Disease Management • Direct-to-Consumer services seeing increased activity • BUT -- must define your focus: • Who are you serving? • What are you measuring? • How will you know you made a difference?

  16. “New” approaches... • Consumer • Willing to pay for some services “out of pocket” • Focus on convenience • Home-based • Grocery store, Walmart, Walgreens • Employers • Also interested in convenience • Keep employees at work, when possible • Berkshire Hathaway/Amazon/JP Morgan • Haven • Unfolding!!!

  17. Keeping up with technology... • Most used methods • Live Video, 46% • Remote Patient Monitoring, 41% • Growth of Store and Forward expected • Current usage, 26% • Adoption within three years, 91% • Challenges • Mergers (vendors and health systems) - platform interoperability • Ensure integration with EMR/patient portals • Speed of technology life cycle and the expense of upgrading 2018 Vidyo Adoption Survey Results

  18. The goal really hasn’t shifted...

  19. It is about health... • Identifying what is important • Cost • Quality • Satisfaction • Access • Convenience • The health of our patients • Figuring out how to address it • As mentioned earlier…training providers how to use it • Nurses -- across the region

  20. To do that we need to: • Listen to the patients • Engage with patients • Reduce the complexity of accessing care • Support the ability to practice at the “top of license” • Create and support reliable, yet flexible, relationships • with patients • with rural-based providers • with the communities in which we live and support

  21. ...and meet expectations • According to a recent Kaufman Hall survey, only 8 percent of hospitals and healthcare systems are meeting consumer expectations. The other 92 percent have yet to align their services with what today’s patient-consumers want and expect. • A recent American Well survey indicated: • Physician adoption of telehealth shot up 340% from 5% to 22% between 2015 and 2018 • Doctors’ willingness to use technology grew from 57% to 69%, driven by the desire to improve access, reduce burnout and improve patient outcomes (disparity between willingness and actual)

  22. This isn’t really about telehealth... • It IS about the role telehealth can play to... • Reduce barriers to care • Improve access to services • Support patients ability to understand and manage their health • Telehealth is a tool... • For all aspects of care (primary, specialty, emergency, long-term) • To be used by many kinds of providers • To serve patients, regardless of the... • Zip code • Time of day • Stage of life

  23. the future is nearly here... Tele-

  24. the future is nearly here... Health

  25. Where to learn more... • Talk with the various large systems to understand what they are doing and why • Talk to your patients and communities to understand what they want • Talk to your peers to understand what they are doing and the challenges/successes they have experienced • Talk to gpTRAC and the Telehealth Resource Centers for information, contacts, and resources

  26. gpTRAC and the National Consortium of TRCs

  27. gpTRAC Provides Resources • www.gptrac.org (toolkits, assessments, sample forms) Contacts • A national network of telehealth programs, and close relationships with many programs in the Great Plains region. On-site Training and Consulting (by contract) • Clinician effectiveness with video and other technologies • Site evaluation and readiness • Resource for discussions/decision making Annual Conference • April 28-30, Minneapolis, MN • Hope to see many of you in a couple of days!

  28. Contact Information Mary DeVany, MS Associate Director medevany@umn.edu (605) 360-6279

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