What is Telehealth? It is one of the fastest growing segments of the healthcare industry, yet it remains elusive and widely misunderstood. Much of the confusion lies in the fact that the technology involved is moving faster than the legislation supporting it, leaving the country with a patchwork set of guidelines and regulations that vary from state to state in regards to how telehealth technology can be used and reimbursed.
First, let’s define Telehealth
It “is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status” (American Telemedicine Association). The way in which information is exchanged via telehealth can be categorized as either asynchronous (lag time) or synchronous (real time).
Asynchronous (lag time): Often referred to as “store and forward” this technology captures and collects health data to be retrieved on-demand at a future point in time. The most common type of asynchronous telehealth in use today is the sharing of health information between providers. For example, an x-ray is captured and saved to PACS (Picture Archiving and Communication System) for an offsite radiologist to view and dictate findings at a future point in time. A less widely used (yet growing) asynchronous use of technology is two-way communication between patient and provider. The most common use of this today can be seen through patient portals and the ability to directly communicate with your provider via email.
Synchronous (real time): Creates a virtual care environment where a provider can act on real-time patient data. Synchronous telehealth between providers is most common as a means to treat patients that do not have readily available access to specialist care. Virtual visits and consults between provider and patient are an exciting and growing use of technology to deliver healthcare to patients directly in their home or at another convenient location. Virtual visits increase patient convenience, enhance access, and expand Primary Care Providers’ capacity to see and treat more patients.
Telehealth Industry Overview
The telehealth industry consists of hardware such as cameras, patient kiosks and consoles, medical equipment, and mobile/wearable devices. Many software vendors and start-ups have also entered the market providing software platforms that support telehealth delivery. The industry has seen explosive growth and that is expected to accelerate in the years ahead. Perhaps Rene Quashie said it best when she was quoted in a recent article stating that “after many false dawns, telehealth has truly arrived” (Rene Quashie).
Market forces influencing Adoption
There are many forces that have led to the recent growth in telehealth and will continue to accelerate its adoption. Most notable is the legislative activity that continues to reshape the industry. According to a study by the Center for Connected Health Policy, during the 2015 legislative session more than 200 pieces of legislation were introduced in 42 states. Currently, 29 states have enacted laws requiring that health plans to cover telemedicine services.
At a federal level congress has introduced a number of telehealth-related bills including:
- The Telehealth Modernization Act, which seeks to establish a federal standard for telehealth and clear up confusion from myriad state policies.
- The TELE-MED act of 2015 permits certain Medicare providers licensed in a state to provide telemedicine services to beneficiaries in a different state without having to be licensed in that state.
- The 21st Century Care for Military and Veterans Act aims to expand access to telehealth to veterans and their families.
- Lastly, CMS has announced changes to Medicare’s physician fee schedule to expand coverage incrementally for various telehealth services.
Other forces: Consumer expectations of convenience, an aging population, increased evidence of chronic diseases, soaring healthcare costs, and pressure to reduce hospitalizations and shorten length of stay.
SEI’s 5 Keys to Successful Telehealth Program Design
In our experience, there are five main keys to success while designing a Telehealth program, as follows:
- Start planning now – if you haven’t already!
The window between innovator and laggard is quickly closing in regards to telehealth. Those that anticipate and embrace the proposed legislative changes will have strategic plans in place today that support the use of telehealth tomorrow. - Develop a clear leadership structure and project governance
It is important when developing a telehealth program to have the leadership and governance structure in place early in the strategic planning process. Telehealth solutions involve many stakeholders throughout the organization and it is critical to have an inclusive process that is driven by a leader committed to hearing the needs, goals and priorities of all. - Map out the various telehealth solutions and the impact on organizational goals
Use of an affinity map or prioritization matrix to map out all of the telehealth solution options and their impact on organizational goals can be powerful in selecting the most effective strategy. - Have a realistic and comprehensive assessment of organizational strengths and limitations
Developing a strategic plan often requires a realistic and comprehensive assessment of organizational strengths and limitations. Telehealth is not a one-size-fits-all solution and it is important that you invest the time and energy upfront to complete an internal analysis and customize a solution that fits your organization. - Create a 3 year strategy or road map – and revisit it frequently
A plan developed today could look vastly different six months or a year from now as new legislation passes into law or new technology hits the market. It is important to revisit your strategic plan often and adjust as changes unfold.
SEI offers a wide range of Healthcare capabilities and vast experience in strategic planning across industries. To learn more about our work in Healthcare or to inquire about telehealth strategic planning, contact us.
