Telehealth – The Future Is Now

By Nicole Fletcher,

In America we spend one third of every dollar on healthcare; that’s dangerously close to $4 trillion. Telehealth is one part - and a big one at that - of the future of healthcare to reduce costs, increase preventative care and improve patient engagement. Telehealth is expected to grow by $5 billion in the next 5 years. It is the only viable solution to date that could alleviate the costs associated with the 70% of doctor appointments and 40% of ER visits that could be handled via telephone. The redefinition of healthcare as we know it marks an entirely new era of doctor-patient relations; one inspiring medical possibilities we’ve yet to fathom. We’re on our way to the American Telehealth Association Annual Meeting next week in Los Angeles and, in honor of the event, we thought we’d take a moment to highlight the latest developments - along with the proclamation that telehealth isn’t a future medical advancement - it’s happening now.

From patient engagement and doctor time-management, to claims processing and provider reimbursement, there are inevitable and necessary process evolutions integral to a positive telehealth experience. In this post, we’ll discuss the existing benefits, the challenges facing widespread adoption, and what exciting possibilities the future of telemed holds.

 

The Benefits:

Telehealth is more time efficient and therefore, less expensive.

Telehealth visits free up doctors’ time to focus on more urgent patient needs. A majority of medical needs can be assessed and referred via telemed, giving docs in the emergency room the resources and bandwidth they need to address the most severe cases. For normal visits, instead of running from room to room, quickly reviewing patient information on the fly, telehealth docs are provided relevant patient information prior to the call, thereby reducing appointment time of 30-60 minutes, to less than 10. This drastic time and overhead savings (office rent, staff, and often even malpractice insurance) allows doctors to do more, with less.

 

Telehealth increases patient engagement.

Knowing where and with whom to schedule an appointment, getting there, and scheduling followups, referral appointments, etc. is a labor intensive and frustrating process, thereby discouraging patients from putting their health first. Efficient, transparent and cost effective telehealth visits keep patients engaged, satisfied and encouraged to incorporate preventative health measures into their busy lives.

 

Telehealth - Insurance Partnerships reach more people.

Telehealth companies like Doctors on Demand (who uses PokitDok to submit insurance claims) are partnering with insurance companies and health systems to provide additional ways to offer medical care to their subscribers. This opens a direct and trusted line of communication from telehealth companies to insurance network members, increasing awareness, education and adoption of the service.

 

Telehealth supports the democratization of healthcare.

Widespread telehealth adoption eliminates location as a barrier to accessing specific, quality healthcare. That means that if there is a specialist across the country - or the world for that matter- who is an expert in the condition you have, it is now possible to access that physician virtually. This opens up an entirely new realm of targeted doctor-patient relationship opportunities, giving docs the ability to have anyone with an internet connection as a patient, and vice versa. Further, it provides, perhaps for the first time, a viable, cost effective solution for ‘medical deserts’ in rural areas.

 

Medicare now covers remote chronic care management.

A new CPT code has been added - 99490 - to offer greater reimbursement for physicians, “developing and implementing a care plan for a patient with at least two chronic conditions that are expected to last at least 12 months or until the death of the patient; or that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline,” according to the Center for Medicare and Medicaid Services. This code was introduced along with seven other procedure codes for wellness, psychotherapy and longer office visits. 25% of the nation’s adult population has multiple chronic conditions, the care of which accounts for 66% of the nation’s overall healthcare spending. If the appointments needed to treat these could be conducted via telehealth solutions, both the cost of patient and doctor time, along with office overhead would be dramatically reduced.

 

Telehealth saves employers money.

Perhaps surprisingly, absenteeism, due to doctor appointments, is a major financial burden to employers. From the time spent scheduling a consult, regular appointment and follow-up, and travel to and from those, employers stand to lose hours of paid productivity. Similarly, when employee ailments progress, overutilization of the emergency room becomes a time and cost intensive issue (especially if the employers are self insured). Telehealth solutions offer proactive options to all of these burdens. Employees are not out of the office for hours on end and they can address health needs proactively, thereby saving time, sick days and advanced health issues in the future.

 

The Challenges:

Reimbursement

Only 25 of 50 states allow for telehealth reimbursement today. Eleven reimburse for telehealth consultations, but do not permit prescriptions to be written as a result of those visits. With time, increased patient demand, and improved telehealth service to insurance connectivity (which is of course, one of our solutions), this process, and likely, future legislation, will be refined to address market demand.

 

Licensing

While in theory, telehealth services give patients access to docs nationwide, in order to be seen by those providers, they need to be licensed in their patient’s state of residence. This process takes approximately 90 days to complete and while not difficult, it is relatively time consuming and a potential deterrent to doctors thinking about getting into the telemed space.

 

Trust

Like mobile banking was to the financial industry, redefining the public’s definition of a doctor’s appointment is no easy task. With time and authority buy-in to guide the way, people will trust that these doctors have just as much authority and knowledge to give them the best care possible, in less time, for less money.

Stay tuned for part two of this telehealth series where we’ll get into what is being done to address some of the challenges above, along with a deeper dive into our telehealth solutions.

 

The opinions expressed in this blog are of the authors and not of PokitDok's. The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice.

The opinions expressed in this blog are of the authors and not of PokitDok's. The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice.

  Tags: Dev, Enterprise, Providers, Telehealth

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  Comments: 3

  1. Wayne Caswell


    I'm a telehealth advocate and support your article but think you need to get the numbers right. Current spending is at or just below $3T/year, not $4T, but either way, the potential savings are huge.

    As important as telehealth is, the most profound trend is the move away from our fee-for-service sick care system, with its profit incentive to view patients as paying customers, diagnose illness, and treat symptoms to keep them coming back, paying. The model promoted by U.S. Surgeon General Vivek Murthy, M.D. is one of wellness and prevention, and telehealth can certainly play a role in that.

    The potential cost savings are huge, because we currently pay twice as much as other nations for health care (about $3 trillion/year), but we still live sicker and die younger, according to the WHO. So in theory, Murthy’s wellness & prevention model could help cut expenses in half at least, saving over $1.5 trillion each year while improving care quality and customer service. After all, 80% of care expenses now go toward treating chronic illness, and 70% of that is preventable, mostly through lifestyle change. With such savings, we could quickly pay down the national debt while also improving workforce productivity and GDP.

    But the medical industrial complex (hospitals, insurers, drug companies, testing companies, and equipment providers) is not excited about losing half of its revenue so has been spending twice as much on political lobbying as the military industrial complex. Here in Texas, the Medical Board requires a face-to-face visit before allowing telehealth, and that's just one way of slowing telehealth. As long as Citizens United allows unlimited campaign contributions, and politicians are pressured to take those (bribes) in order to remain in office, we likely won’t see public policies that support Murthy’s prevention-based society. That’s why it’s so important that he take his message to the public at large, and I commend him for that.

    If Dr. Murthy is successful, and we as a nation were to really focus on prevention, what might we demand that Congress do? Well to start, they could address poverty, the food supply, and environmental contamination that contribute to poor health. Then to support corporate wellness programs, they could encourage employers to prioritize sleep, which is an often-ignored pillar of health, along with nutrition and exercise.

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