It is funny how you can start reading something and after the first sentence, not only lose the desire to read the rest but start to mistrust all you are reading. This happened to me when I settled into work my way through the 16 pages that make up the AHA Report on Telehealth Resources.
What derailed me was the simple sentence: “Telehealth is part of a larger digital transformation in health care.” While that may be true, it hints at the problem with the current view of Telehealth by many healthcare providers. The problem is doubled down by the next sentence: “The electronic health record (EHR), omnipresent mobile devices and faster internet connections have provided new ways for patients and providers to interact.”
Here is my problem: While it may be a prerequisite for the healthcare system to have an EHR to make telehealth as useful as it can be, it may not satisfy requirements for the patient.
The AHA Report on Telehealth Resources separates two different audiences for Telehealth. They suggest you can achieve benefits in a Provider-to-Provider model and a Direct-Consumer model. Of course, it makes sense that technology can be used to accelerate the performance of the healthcare supply chain. It also makes sense that we can achieve savings from the way you care for patients. Data from Jefferson Health they quote, shows that 80% of emergency virtual visits resolved the episode of care without the need for a trip to the emergency department.
All the data in the report reminds me of the old joke about hospitals (or any massive bureaucracy). You know what the problem with this hospital is, the joke asks? It’s the patients. If we could get rid of them, this place would work correctly.
To understand how to transform healthcare Telehealth, you have to start thinking patient-in not healthcare-out.
Does Size Matter?
Another interesting part of the report is how it compares Telehealth experience by size or type of provider. Take one area of deployment: remote-patient monitoring post-discharge. Here are the implementations by provider type:
Health Systems 45%
Academic Medical Centers 33%
Community Hospitals 19%
Urban Hospitals 10%
Critical Access Hospitals 9%
Rural Hospitals 4%
While it should not be surprising the large Health Systems and Academic Medical Centers get the best results, it may be the most significant benefit could be for Rural and Critical Access Hospitals. The most value will be derived by patients who have to travel the longest to make an appointment. Additionally, they are also the ones that struggle most with time wasted by delayed or canceled appointments. My recently primary care visit started with the nurse saying, “Oh, sorry, didn’t we tell you, the Doctor has a meeting and will be running late?” She had no idea how late, and completely missed the point of me making an 8 am appointment so it would not affect my work day. I only had to drive 5 miles, and I was frustrated. Imagine driving 50 and finding the same thing.
Think Consumer First
It is frustrating for some doctors when you call their patients “consumers”. My guess is they don’t like them to be known as consumers because in some ways they think it devalues their skills. That is not the intent.
At Wellsmith we call patients “consumers” because it implies they have choices and rights. We are here to serve them, to integrate our services into their lives and not the other way around. We put them in the middle of our world and try and rotate around them. If you want tele-anything to work, that’s how you have to think.