As healthcare organizations grapple with the best methods to reduce costs, improve the patient experience of care and improve the health of populations—initiatives collectively referred to as the “Triple Aim”—telehealth is showing great promise in achieving these goals.
The ability of telehealth to meet these objectives has been studied for over 20 years. However, the convergence of cost pressures, improved technology and changing consumer preferences have underscored the importance for organizations to align their telehealth strategy to the principles of the Triple Aim and, ultimately, support a more engaged patient.
Leveraging telehealth can support the Triple Aim by helping organizations more effectively meet these three objectives—here’s how.
High-deductible health plans comprise 25 percent of employer plans and expose consumers to greater healthcare cost burdens. One way telehealth can help reduce costs is by incentivizing patients to take advantage of lower cost telehealth visits through reduced (or zero) co-pays, especially as new telehealth services are introduced. A 2014 study found the average cost to a clinic for a telehealth visit is $40 to $50 compared to $136 to $176 for in-person acute care, saving roughly $100 per visit. This can help reduce a patient’s out-of-pocket cost.
Telehealth also can reduce costs by:
- Reducing readmissions with better follow-up care. Personalizing the experience and removing barriers to post-discharge follow-up care are keys to delivering greater patient engagement and reducing penalties for readmissions, which are expected to grow 25 percent in 2017 and reach more than $500 million.
- Improving staff utilization with e-consults by reducing the need for physicians to shuttle between locations and enabling them to focus on what they do best: delivering high-quality care in the most appropriate care setting. With providers incented to take on more risk to manage patient populations, hospitals become cost centers. Kaiser Permanente reported that 20 percent to 30 percent of their current in-person visits could be handled in alternative venues resulting in less reliance on expensive facilities. In another example, Compass Urgent Care, Mobile, Ala., can cite cost savings as a result of implementing a branded telemedicine solution from eVisit, which helps doctors treat patients with minor ailments that do not require a medical exam or prescription of a controlled substance. Doctors at Compass Urgent Care have treated 242 patients with an average length per visit of only 14 minutes. It costs patients just $49 for a video consultation, providing nearly $5,500 in incremental revenue to the practice in less than four months.
Improved patient experience of care
There is quantifiable evidence that measuring quality outcomes and patient experience leads to quality improvement. When integrated effectively into the care delivery workflow, telehealth improves the care experience by giving patients more access to care with less disruption to their lives. The key is delivering an experience that delivers resolution, moves patients to a more appropriate care setting and/or supports their post-discharge care. Using telehealth to improve patient experience results in:
- Less anxiety. Studies have shown that many patients suffer from increased anxiety when visiting a physician's office or hospital setting. Combined with flexible scheduling options, this results in greater adherence to appointment times and is less overwhelming than visiting a doctor's office.
- Convenience. Patients in rural areas often drive several hours to meet with a specialist. This also creates a significant financial impact that includes both time out of work and travel expenses.
- Preferred engagement. In a recent survey, respondents under the age of 45 indicated digital as their preferred means of engagement to manage their health, outranking traditional facility visits or phone calls. For example, CentraCare, the urgent care arm of Florida Hospital, adopted eVisit’s eCare several months ago to help improve the patient experience. Patients prefer to see a provider and resolve their issue in less than five minutes from their homes, Florida Hospital executives say.
Improved health of populations
According to the Administration on Aging, there will be over 70 million older adults (age 65 and older) living in the U.S. by the year 2030, more than twice the number of older adults living in the U.S. in the year 2000. This increase in the aging (and relatively sicker) population places pressures on a healthcare system already struggling to keep pace in caring for this population.
Telehealth allows providers to see more patients in less time, receive remotely generated health-monitoring information about patients for improved response times, and provides ongoing, interactive patient education. Telehealth can improve the health of populations by:
- Increasing patient-provider interaction, which can result in better outcomes for patients. For rural patients, telehealth provides greater access, specifically to specialty care providers who might not be in their geographic area.
- Improving treatment of chronic conditions, which can lead to a reduction in mortality rates. Aetna patients who used a telehealth program had 31% fewer hospital admissions over six months than those using traditional therapies, 48% fewer inpatient hospital stays, and about 27% fewer emergency department visits.
- Providing greater access to specialists which improves the accuracy of diagnosis and care. Focusing efforts on conditions leading to Medicare penalties such as heart attacks, heart failure, pneumonia, chronic lung disease, hip and knee replacements and coronary artery bypass graft surgery, are care paths to support.
Implementing telehealth best practices
Critical in delivering an enterprise-grade benefit are your organization’s strategy and implementation and adoption plans. To increase your organization’s chances for success:
- Ensure that telehealth is part of your organization’s broader digital and virtual health strategy that has top level executive support and a long term financial plan.
- Start small and build your project plan around a single specialty, establish best practices around care resolution and then scale up. Adoption starts with a patient-centered approach, but must be supported by an effective change management process to deliver clinical adoption.
- Insist on embedding telehealth options within the organization’s business processes. For example, during discharge provide the patient with an option of in-person or telehealth (phone and video) follow-ups. This will require re-training staff to support care delivery and educating the patient on options.
- Clearly understand state-specific licensing requirements, embed the relevant telehealth payment codes directly into the workflow and make it simple to collect payments.
To realize the Triple Aim opportunity of telehealth, health systems need to meticulously plan the integration with the hospital IT/EHR data, including data security implications. Otherwise, telehealth will remain a consumer-directed activity, not an enterprise-grade benefit. Ultimately, lower costs and improved outcomes will incent utilization but personalization will drive true patient engagement.
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