Virtual Care is No Longer “If” But “When”

“To create one contagious movement, you often have to create many small movements first.”
Malcolm Gladwell
The Tipping Point

What series of factors come together to create a storm so perfect that new technology takes off? That’s what Malcolm Gladwell’s book, The Tipping Point, ties to define. HealthLeaders suggests we’ve reached a tipping point of sorts for telehealth technology, a point in the technologies history where it’s not a question of if you’re providing connected care, but when.

While telehealth has been around since the 50s, it’s been a novelty until now. Larger healthcare organizations such as the VA, have been the earliest adopters of these tools, and their outcomes have proven the efficacy of the technology to improve healthcare outcomes and cut costs. Today, with healthcare costs skyrocketing, these organizations are seeking new ways to expand these services and increase adoption levels. The most recent polling data shows that 76% of U.S. health systems and hospitals have a telemedicine service line available or in the works.

With outcomes already established, telehealth is poised to become the go-to tool for healthcare providers seeking to:

• Improve patient access to care;
• Offer more affordable healthcare alternatives;
• Offset the physician, midlevel, and nursing staffing shortages;
• Eliminate geographic and economic disparities in rural communities;
• Keep elderly patients in their homes longer;
• Improve healthcare outcomes for chronic diseases.

HealthLeaders says, “This is one of those rare occasions when business strategy coincides with an opportunity to enhance patient care and improve health outcomes.” They argue that clinical providers of all sizes cannot afford to ignore patient care delivery via telehealth. With the onset of a host of phone apps that have democratized the formerly expensive proposition of telemedicine kiosks in hospitals (including OrthoLive for orthopedic providers), virtual care is now poised to go mainstream.

Monica Oss, in an Open Minds Executive Briefing, predicts 2019 will define telehealth’s tipping point under Gladwell’s definition, stating that she believes there are several key factors that will launch telehealth from an outlier to a standard and integrated part of accepted medical practice this year:

• Health plans are embracing telehealth. Some of the latest research shows that 96% of all private health plans and 50% of Medicaid health plans now offer, at a minimum, telemental health services. Of the private payers, 41% of these offer eCBT, which is Apple’s app for Cognitive Behavioral Therapy. Another 21% use an online patient engagement tool and 16% use patient-facing online portals.
• Employer health plans are pushing telehealth, and 96% say they are expecting to offer the service. More than 56% are offering telemental health for their employees, which have doubled from last year.
• Reimbursement and policy changes from CMS that have included more latitude in how they pay and who providers can offer telehealth services to under Medicare and Medicaid. Starting in 2020, for example, CMS will offer telehealth options under their Medicare Advantage plans.
• Telehealth expansion in the VA was huge in 2018, with the organization moving to allow providers to practice across state lines, telehealth service line expansions, and more. Even the Department of Defense (DoD) jumped on the telehealth bandwagon, making changes to TRICARE that required virtual visits be reimbursed in the same way as in-person visits.
• New telehealth outcome data is being published regularly now. From remote monitoring improving outcomes for chronic care, to autism diagnoses proving to be just as accurate for in-person as telehealth, more evidence-based data is showing the efficacy of medicine enabled via the virtual visit.

While current telehealth adoption rates are sporadic, at best; for example, employers report a current adoption rate of only 8%, these numbers are steadily increasing. And, increasing studies show that consumers are comfortable with telehealth technology.

Today, healthcare providers have launched, or are initiating dozens of programs to manage chronic diseases for growing patient populations. These programs seek to use remote sensor devices like pulse oximeters, activity monitors, EKG units, blood pressure cuffs, or other technology to measure and track patient care in their homes. It’s a necessary response when healthcare data shows an aging baby boomer population with chronic diseases will drive the cost of providing care to unprecedented levels in the coming years.

“I think the digital transformation is as big or bigger than the transformation from paper records to the EHR. It’s not just moving from paper to computer, it’s moving from [interacting with] patients in our office, to [providing care to] patients in their home or at other healthcare facilities. That’s a difficult thing for many physicians to wrap their heads around.”
Peter Rasmussen, MD
Medical Director of Digital Health
Association Professor
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University

Ironically, while the perfect storm of internal and external factors have pushed digital healthcare to the tipping point, there is one issue still standing in the way of widespread adoption; physician reluctance. Leveraging telemedicine requires a fundamental shift in the doctor-patient relationship. Sadly, some physicians will simply fail to embrace the technology and will fall behind their peers and consumer demand.

Overcoming physician reluctance around any technology adoption in a field that is exhaustingly rife with change is one of the biggest hurdles for any change management process. But the almost-sacred traditional in-person patent encounter workflow can feel threatened by the idea that equally effective care can be given from a computer screen.

Monica Oss, in her Open Minds Executive Briefing provides some insight into the number one factor that will ultimately force even the most reluctant physician into telemedicine adoption:

Slowly and surely, I think telehealth will change the way consumers think about getting health services. Consumers will likely use the physical on-site services less frequently in favor of more on-line services. They will expect convenient “on-demand” services, price transparency, and easy payment processes (even for complicated copayments and deductibles). This isn’t a world of “virtual” health care, it is a world of tech-enabled health care where the service delivery system is a seamless hybrid of physical and virtual services.

OrthoLive is ready to help orthopedists embrace this technology as a tool to improve their practice bottom line. Contact our team to discuss your options.