Everyone has heard of Telehealth, which is the broadest term possible for anything related to the provision of remote care in pop culture. It encapsulates telemedicine, which more strictly applies to care provision between a doctor and a patient, mhealth which is the delivery of care via mobile phones, and so much more.
While Telehealth may seem like a healthcare industry buzzword, it’s interesting to know that the concept came into being in 1925. Inventor Hugo Gernsback proposed the “Teledactyl”, a machine through which doctors could both see and feel their patients remotely (see pictured). 95 years later, there isn’t a household device as envisioned by Gernsback, but we do have mobile devices such as the phone and the tablet, through which care givers can remotely observe and monitor patients, albeit not feel them as the “teledactyl” had predicted.
As it turns out, the mobile capabilities of our current devices were enough to stir up a storm in healthcare in the past decade and lead to what we now call Telehealth, remote care or mhealth. Take your pick, as they are often used interchangeably. The nature of telehealth made it beneficial for multiple stakeholders to adopt it. It was our intention to come up with a master list of such reasons for adoption. By crisscrossing multiple sources of information, we were able to come up with a grand total of 50!
Without further ado, in no particular order, here are 50 reasons explaining the rise of Telehealth in USA.
50. Backed by Academia
Telehealth’s implementation in the healthcare industry is a well-researched topic. While there are multiple angles to research the topic, the patient satisfaction that is a consequent of using telemedicine is a highly studied subject. After studying 2193 articles in well-known medical journals, patients favored telemedicine because of both efficiency and effectiveness factors. The top reasons for patient satisfaction were improved outcomes, preferred modality, ease of use, low cost, improved communication and decreased travel time. Hence, telehealth is a concept embraced by its end users, I.e., the patients.
49. Bridging the Gap in Rural Areas
Critical access hospitals have done a wonderful job at bringing quality care closer to rural areas who might otherwise be removed from it. But the further away one moves from the city center, the more difficult it is to get access to multiple healthcare resources, all of which may be necessary to provide a full-fledged healthcare service. Telehealth helps further narrow this degree of separation by letting the patient coordinate and execute a care strategy with doctors, nurses and pharmacists the same way they would do by being closer to an urban area. While it’s not possible to completely replicate the physical infrastructure in rural areas, people can come together virtually to provide top notch care which truly is accessible anywhere.
48. Enabling Home Care
While Telehealth need not be relegated to just home care, research has shown that patients recover faster when they are home. For complex conditions such as dementia and Alzheimer’s, it promotes healing in a way which cannot be replicated inside a hospital setting. Thus, while Telehealth has benefits that span beyond just proving a remote connection, it can in fact enhance the quality of care by simply by keeping patients in a more familiar setting.
47. Climate Change
Natural calamities have increased in recent times due to the rise of ocean temperatures. More hurricanes and typhoons displace people and temporarily severe them from healthcare access. In such times, the value of telemedicine shines forth brightly. Case in point is Hurricane Florence last year, where virtual care vendors and providers worked together to provide free telehealth services to those affected.
46. Shortage of Healthcare Professionals
The Association of American Medical Colleges predict a shortage of more than 90,000 doctors in USA by 2025. With only so many care providers going around in the country, there is greater impetus on using telehealth, where doctors can increase the number of patients seen daily. It’s possible to streamline the process of delivering care by avoiding lags in the system due to patients not showing up, showing up with an insignificant issue, and by eliminating the time it takes for a person to comply with procedures in a hospital. Thus, the quality of care is maintained with the same number of physicians at an organization’s disposal.
45. Telehealth Parity Laws
35 US states, and District of Columbia have passed Telehealth parity laws which mandate private payers to reimburse for telehealth services the same way they would do for an in-person visit. This incentivizes health systems and physicians to provide telemedicine services knowing that they will not be undercut or lowballed by the payers. It is wonderful news for Telehealth practitioners and patients alike, who have always wanted to use the service but had reservations because of the lack of fair reimbursement.
44. Reduced Exposure to other Sick Patients
One of the risks of going to hospitals is being in close proximity to contagious diseases such as the flu, cold or strep throat. While infection control steps are being taken by the hospitals, they are not foolproof. Even more alarming are hospital-acquired infections from super bacteria which can cause irreparable harm. Thus, it is a safe choice to avoid hospitals all together unless it is absolutely necessary. Telehealth systems make this a reality, where you can receive care remotely up to the point where the situation necessitates a hospital visit.
43. Reduced Waiting Time
Nobody likes to wait. It creates bottlenecks in a system’s workflow, thereby hampering it from achieving optimum efficiency. Waiting time to get an appointment, or time waited in waiting rooms are metrics which are commonly used to evaluate a healthcare system. The American Journal of Managed Care found out that patients spend on average 84 minutes in the waiting and exam rooms. Both these things are reduced significantly when you handle the administrative tasks on a remote device.
42. Democratization and Transparency of Healthcare
The healthcare system in the USA is commonly referred to as a maze, and can be difficult for first time patients to navigate. Some of the Telehealth vendors have brought a level of transparency into the system, whereby one can see reviews of physicians in one place before making a choice. There are also price comparison features by which one better choose the path they want to take. Such conveniences were not so readily available before the advent of Telemedicine.
41. High Professional Satisfaction
Physicians need to be happy at work, whether that means better stress management or reducing burden from miscellaneous duties. With Telehealth programs, physicians have greater authority to set their own schedules, being able to distribute workload more evenly as the requests come in via technology. Such flexibility offers better work life balance. They can also focus on handling the type of cases which they are better suited for, by delegating low intensity cases to allied health providers, or more unique cases to the specialists. They are also able to better communicate with fellow caregivers and their patients, bringing everyone on the same page much quicker. Such perks result in a much higher physician satisfaction.
40. Looming Industry Disruption
Laws of product diffusion says that there are innovators, early adopters, early majority, late majority, and laggards. While Telehealth hasn’t reached a critical mass of the population yet, it clearly is thriving well with innovators and early adopters. When it does cross the chasm from the early market to mainstream, it will ride an irreversible phase of growth. The fact that it is hanging around is a promising sign itself, that there will come a time when it won’t be just used by tech enthusiasts and visionaries anymore, but accepted by pragmatists as well.
39. The VETS Act
Previously, providers were not able to offer telehealth services to veterans across state lines. The VETS Act passed on 2017 changed that. The US house and senate realized it was unfair to deny veterans access to high quality healthcare that they deserved simply because of the source was an out of state provider. At the federal level, understanding the value of telehealth is on the upswing, it’s how the individual state laws mesh with the federal laws that is an issue. It is understandable how states would want to keep control of healthcare channels via laws. But as more people realize just how beneficial telehealth can be, changes are transpiring where Telehealth is becoming a must have to compete, both within state, and in the country.
38. Access to Urgent Care
Urgent Care started to become popular driven by health consumerism, where people valued walk in visits much more than appointments when it came to choosing a method of healthcare delivery. Virtual visits take it a step further, where you don’t even have to leave your house for your first point of contact. Chiron Health lists urgent but nonemergency complaints such as conjunctivitis, diarrhea and urinary traction infections among those that can be treated remotely. Indeed, by offering Telehealth, there is a possibility of further consolidation in the industry where one provider can walk a person through their entire patient journey.
37. Security
With more awareness about privacy breaches lately, security is one major barrier when it comes to the adoption of new goods that involves data. Thankfully, there were always very stringent regulations in place in healthcare, chief among which is the HIPAA act. So it’s easy for telehealth vendors to prove their security merit by being HIPAA compliant. But there are other issues such as external authentication which is a big risk with adopting any technology. But there are techniques in place to ease the nerves such as encryption of data and conducting more frequent penetration tests and vulnerability assessments.
36. Enhancement of Productivity of Hospital Staff
Patients are not the only stakeholders in the healthcare system. The supplier side have many more participants which make a health system what it is. Virtual training delivered via telehealth systems to all such parties makes the hospital staff more productive. It also saves time which they can use to further care for their patients through case management. They also become better users of the new technology in time. With repetition of tasks, greater specialization is achieved in each of their duties. Greater specialization in turn translates to more productivity.
35. Emergency Departments Getting into the Act.
You would assume emergency care is one aspect of healthcare where telecommunication will not suffice, and direct treatment of the patient will have to be expedited. While that is true, telehealth is a tremendous value add on in such emergency scenarios. Such as trauma surgeons directing care at the back of ambulances. Many health systems in USA are rolling out digital emergency care programs such as the Telehealth Express Care Service and Mobile Stroke Unit in the New York Presbyterian Hospital.
34. Emerging Payment Models
New payment models are making Telehealth programs more favorable. One such model is capitation, where a hospital gets a set amount of funds for each patient regardless of whether they seek care or not. In such situations, there is incentive to ensure that every person’s interaction with the healthcare system is as cost-efficient as possible. There is also Bundled Payments, which is a single comprehensive payment that covers for all services in one episode of care. In such instances, telehealth is crucial to provide high value care with multiple touchpoints, while still being cost effective at the same time.
33. The Ability to Earn Additional Revenue
Physicians have one of the most strenuous, if not the most strenuous academic and practical regimen, before they can become licensed to practice their craft. Naturally, they want to make a good return on their investment. Sometimes fixed engagements with one hospital is a hindrance to their financial freedom. Many telehealth companies have risen to fill that void, whereby doctors can fulfill the demand for healthcare on other platforms besides their primary workplace. Companies such as Teladoc and American Well have become synonymous with the industry merely by connecting doctors with patients. While Telehealth is more nuanced than being a marketplace, its potential of being so is for all to see.
32. Improve Clinical Workflows
The technological aspects of telehealth are great because of convenience, but its true value may lie in solving the more complicated. Because it allows for the collaboration between multiple care providers, more efficient workflows can be designed and executed on telehealth platforms. In a teleretinal diabetic screening program at Los Angeles County Department of Health Services, screening rate increased by 16.3% and wait times for screening were reduced by 89.2%. Such efficiencies can be replicated in other forms of specialty care, with proper design of workflows. Such workflows can be replicated in other departments as well, and there are countless testimonies to their success stories.
31. Help Filling out Prescriptions
Filling out prescriptions is an age-old pain for patients, with many complaints hovering around the subject. Telehealth solves this nuisance with the right medications being filled out automatically. Refills are likewise automatically updated. It’s another case of technology reducing unnecessary human administrative tasks, both from the patient’s and provider’s perspective. With administrative duties being automated, more of the mind can be directed at achieving quality. In this case, that would be determining the right prescription.
30. High Patient Satisfaction
Patient satisfaction and telehealth go hand in hand. It’s one thing to have reservations about trying something new, but it is another to maintain those reservations post-trial. What’s great about telehealth is, that people have high satisfaction rates of using telehealth services. It is understandable why this is so, as Harvard Medical School found out that patients a visit to the doctor takes 121 minutes of a patient’s time and costs $43 per visit. Both of these numbers can be reduced dramatically by telehealth. It’s no wonder why patients who have once tasted the benefits of telemedicine consider it a must-have.
29. The Impact of Behavioral Health
One aspect of healthcare where communication alone is a huge component of treatment is behavioral health. It is imperative for the patient to communicate with the psychotherapist frequently. Technology in the form of Telehealth makes this a reality, where convenience is maximized. With greater awareness of mental health issues in recent times, it is important to increase access to mental health, and telemedicine is quick-fire method to disseminate such type of care.
28. Commercializing by Companies
Suppliers have recognized the opportunity demand presents in the ever-increasing consumerism of health. Accordingly, large Telehealth vendors have signed up many high-profile companies whose employer insurance programs put pressure on hospitals to adopt Telehealth programs. Such a trend is set to continue where the sheer demand from private payers generates more buy-in for telemedicine.
27. Great for Rehabilitation Care
In its truest sense, hospital admissions should consist of treatment to restore the patient back to his or her optimal state. By doing this one critical duty inside hospitals, one ensures that everyone gets the basic care that they need. But practically speaking, healthcare is so much more. There are two long tails attached to either side of critical or acute care. There is preventive care, and there is rehabilitative care. Telehealth delivers value on both fronts, but specially on rehabilitative care. This is because while many hospitals have rehabilitative units, the patients themselves want to go home. If proper communication channels and monitoring can be maintained, not only can pressure on these units be reduced, but the patient can be more independent.
26.The SUPPORT for Patients and Communities Act
In 2018, the SUPPORT Act was signed into law to counter the inflating opioid crisis in USA. It allows healthcare providers to be reimbursed by Medicare for telehealth services to beneficiaries with substance abuse disorders. Under the previous laws in the book, such access was restricted. Including the patient’s home as an “originating site” reimbursable by Medicare, shows that the government is serious about providing care to those who need it most. It makes telehealth readily available to a great subsection of patients with substance abuse disorders or co-occurring mental disorders.
25. Improves Patient Outcome
Telehealth would not have gotten the type of acceptance that it did if it did not improve patient outcome. Improving patient outcome has dual benefits for the provider, namely: cost reduction and revenue generation. By achieving greater throughput due to use of telemedicine, one can see a greater volume of patients thereby increasing revenue, and also reduce costs of each patient seen due to economies of scale.
24. Specialization of Departments
Based on research, the modality of telehealth is being tailored to optimize care at various hospital departments. While its value at the primary care level is easy to demonstrate, Telehealth’s real value may lie in fine tuning care at the specialty departments at hospitals. The state of affairs in telemedicine has become so refined that many hospitals actually have units called Telestroke, Teleoncology, Telemetry, etc. In a sense, it has become commonplace, where the question is not whether to adopt telehealth, but how to best integrate it into a particular branch of medicine. Eventually all branches might have the prefix tele attached to it.
23. Increased Patient Engagement
Providing high quality healthcare is a two-way street. Healthcare workers can rescue a dire situation. But for the patient to not relapse, they also need to be proactive in taking care of themselves. Incorporating telehealth devices allows the patient to be more engaged in the process, monitoring their biomedical data, updating their status, and becoming more educated through resources.
22. Increased State Buy-Ins
While the USA is governed by both federal and state laws, sometimes the two can come into conflict. States have to protect the interests of their own constituents, even if the federal government promulgates a certain type of action for all. But to telehealth’s advantage, as every year passes, the states are increasingly warming up to the idea of telehealth. Other than State Parity Laws, which now 35 states have, compared to 29 in 2016, states have different levels of restrictions on policies such as informed consent and store and forward telemedicine. In general, things are progressing where attitude towards telemedicine is becoming less restrictive.
21. Increased Cooperation from EHRs
In terms of technology adoption for communication, EHR in many ways was the precursor to telehealth. So the two are a natural fit. Recently, they have become increasingly interoperable where one can schedule, prescribe and bill in one all-inclusive system. Such a seamless fit only enhances telehealth’s value in the eyes of all parties involved.
20. Governmental Support through Initiatives
We have previously discussed how the government can make a difference through legislature. But there other ways it can have an impact as well other than changing the legal landscape. One of those way is through initiative models which attempt to nudge relevant actors to push for more innovative care delivery models. While there are many aspects to innovation, telehealth is a pre-existing technology that has massive scope of being absorbed into care delivery. Pennsylvania recently was awarded $1,560,134 to develop its State Health Care Innovation Plan. Emphasis on telemedicine is a part of the plan.
19. Greater Access to Specialty Care
If there is a shortage of doctors as we mentioned before, there is even a greater shortage of specialists! Sometimes, the need for telehealth is totally demand driven. Such is one case. People can and do have the misfortune of contracting a disease or suffering a complication for which there are no specialists nearby. In such instances, telehealth is their only option for the short term before something can be worked out.
18. Other Facilities Besides Large Providers are Getting into the Act
Telehealth is no more a high-end good affordable only to large hospitals. As technology and data plans evolve, smaller institutions such as clinics, physician groups and completely solo private practices are beginning to adopt telehealth. In the private market, the goal is to reach patients and get reimbursed, either via insurance companies, government agencies such as Medicare or Medicaid, or by patients themselves in out of pocket costs. The adoption of telehealth by the different types of providers creates a sense of urgency in the economy, where it becomes a necessity feature to reach patients.
17. Rise of Ancillary Industries, Fitness Wearables.
Industry groups exist whose members rise and fall together. If their services are too similar, sometimes they cannibalize each other. Companies from other industries have entered the Health, Wellness & Fitness industry through wearables, such as Nike and Apple who are in the Sporting Goods and Consumer Electronics industries respectively. Nike’s FuelBand was discontinued, Apple’s iWatch’s success is still an unfinished story. But what all such examples have in common is getting the consumer to be more proactive in monitoring health data. Telehealth incidentally, tries to do the same. In the latter’s case, it is a more serious approach of remote patient monitoring, where the consumer is not merely a consumer anymore, but a patient. But it is interesting however, that so many different sectors of commerce have identified this trend of monitoring health data and want to tap into it. It means that there is enough interest at the ground level to self-monitor, whereby telehealth can help prevent diseases.
16. Big Data Analytics
The telehealth technology isn’t just good for convenience, it is powerful gateway to research. By taking the necessary permissions and using the data on the system on each patient, predictive analytics can be performed to obtain greater insights into a certain condition. By virtue of integration with the patient EMRs (electronic medical records), researchers’ access and wrangling of data can be a much smoother process. Hence, medical researchers are yet another stakeholder in the healthcare ecosystem who are vouching for telehealth.
15. Greater Organizational Efficiency
When employee programs offer telehealth on site, employees do not have to take a leave of absence. By able to consult about their own health or one of their family member’s health at their workplace, employees can save a lot of time, and have the peace of mind that is necessary for work. By reducing absenteeism and increasing presenteeism, Telehealth does a lot to drive the productivity of employees.
14. Urban Usage is a leading Force
By its very nature, telehealth should work best when there is adequate distance between the provider and patient. But both rural communities and urban centers are noticing a similar uptake in telehealth. While rural physicians are more likely to avail telehealth, it’s interesting that some studies found rural residents to use telehealth less than urban residents. It makes sense as urban dwellers are more familiar with technology, are more individualistic, and have less time. But urban centers are the locations where population is growing, including the suburbs. This is good news for telemedicine adoption.
13. The Rise of Integrated Health Systems and ACOs
Care coordination is a major challenge for providers, both in terms of finance and the actual delivery of care. For these reasons, Integrated Health Systems and Accountable Care Organizations rose to prominence with their promise of coordinating high quality care to each and every patient they serve. As the importance of healthcare coordination comes to forefront, the demand for tools which enable better coordination also presents itself as an issue. In the context of telehealth, vendors have always positioned themselves as being able to connect multiple care providers, and even other departments such as transportation and billing, to deliver one consistent continuum of care.
12. Increased Convenience
Whether it is to quickly get an answer to a straightforward question, get referred to a specialist, or obtain a prescription, there is no faster method to receive health care than via Telehealth. The idea meshes well with the concept of patient centricity, where it all begins with the patient regarding how they want to receive care, consent to giving their health data, participate in clinical trials, or involve other caregivers besides their primary physicians. Such heights of patient centricity would not be deemed possible if it wasn’t for the mobilization of healthcare.
11. Worldly Care- Across Borders
When there is talk about health, there is a lot of discussion about your family care doctor. Given that human beings are averse to change and like consistency, it is reassuring to be assigned to a general practitioner who knows your medical history better than anyone else. With the advent of telehealth, it means you can communicate with your doctor no matter where you are located. Such facilitation of communication doesn’t stop at the border either, it extends to the whole world. Thus, it is incredibly comforting to know that you will carry your patient doctor relationship with you no matter where you are on the globe, provided there is adequate communication infrastructure.
10. The eICU Phenomenon
Many hospitals have been encouraged by the success of eICUs. Atlanta’s Emory Healthcare saw that eICU patients had lower lengths of stay and were discharged at a healthier state compared to traditional ICU. Many folks only associate Telehealth with outpatient care, but it need not be so. In fact, some of the greatest opportunities of digital care may be inside the four walls of the hospitals.
9. Lowers costs by Reducing Emergency Visits
By reducing unnecessary emergency visits, and all the patient transfer costs that are associated with it, telemedicine saves hospitals millions of dollars. Out of the 136.9 million emergency visits in 2016, 39% of the patients were seen in fewer than 15 minutes. There is clearly a lack of knowledge of what to do in such situations. But it is a pricey gap of knowledge, as it heavily costs hospitals in terms of resources. With greater utilization of Telehealth, such a problem can be easily fixed.
8. Empowers the Patient through Remote Monitoring
Patients are in control of their own lives when they are properly educated on the protocols they need to follow regarding their cases. Remote monitoring helps this cause, as patients are educated on the optimum levels needed to maintain health. Such an occurrence does not mean abandoning the patient, rather a highly valuable, both monetarily and in terms of the quality of care provided can be maintained with a patient. It gels very well with the idea of accountable care.
7. Improved Medication Adherence
Telehealth leads to higher medication adherence which is related to better patient outcome. Approximately half of patients who take medication do not properly follow physicians’ orders. They cost hospitals an estimated $310 billion in avoidable costs. With proper medication reminder features, such an easily fixable problem can be addressed. While there are many apps for such a practice, a proper platform used by the hospital itself and given to its patients can drive the necessary engagement from the patient’s side of things, and ensure greater accountability.
6. Millennials more likely to adopt telehealth.
Millennials, or those who are currently aged between 22 and 39, are a major driving force of the economy and spend about $200 billion annually in USA. They are also tech adopters, especially the younger millennials who do not want to be marketed to, but rather want to partake in the research process when it comes to buying options. 40% of them say that telemedicine is an important option to have. Thus there is tremendous potential to better educate this cohort, whose attitudes are more suited for digital health.
5. Patient Recruitment and Retention
Telehealth provides a tremendous differentiation point for providers. Its utilization does not only provide operational advantages, but promotional advantages as well. When more people are healed or have a positive experience directly or indirectly a la Telehealth, they are likely to spread the positive outcome via word of mouth, and create marketing buzz for the healthcare brand in question. Patients who recover quicker, or get answers to their questions immediately, and taken care of by multiple providers in a systematic way, are likely to be strong brand advocates.
4. Moving away from FFS to PFP.
Fee for service (FFS) is a quantity-based approach where providers are paid for every procedure, which may lead to overutilization of procedures and cost inefficiencies. More and more large healthcare systems are moving towards pay for performance (PFP) which is a quality-based approach, where pay is tied to the outcome of the patient. Hence, care delivery is better suited to employ coordination. PFP will always favor more innovation than FFS, as reimbursement is tied to performance and not the existence of a service. Thus there is greater motivation to tinker with the service to produce better results. Telehealth is one such opportunity to update the service to something more productive.
3. Reduce readmission rates
Ever since CMS took a stance to deliver better quality care centered around outcome, it started to penalize 30-day readmissions. Providers scrambled to reduce this rate. Having a telehealth system in place allows the reduction of 30-day readmissions of various diseases, most notably the ones included in CMS’s Hospital Readmissions Reduction Program. Aetonix was able to reduce Lennox & Addington’s 30-day COPD readmissions rate from 23% to 3.4 %.
2. Changing demographics
Demographics determine the cost of healthcare. And in first world countries such as USA, the number of senior citizens are increasing every day. While this is partly due to the advance of healthcare, one must realize that reducing mortality is only the beginning. One must then ensure that the elderly population live their best lives. In order for this to happen, there needs to be a lot of coordination amongst various care providers, which becomes impossible to do if there isn’t a central tech platform enabling it. This is where telehealth steps in.
1. Rise of Chronic Care Patients
There are many different types of healthcare visits. Some are preventive, some treat an actual disease with the patient expected to recuperate fully, some are acute in nature which fix an urgent question. But with an aging population, there is a fourth branch of healthcare where a person needs care over an elongated period of time, perhaps till the end of their lives. When you have multiple comorbidities, the need for a holding hand becomes obvious. When not in a hospital, such a segment of population still needs to be cared for every day, and telehealth enables it.
I hope you got value out of this article on why Telehealth got the steam it did because of reasons covering the entire PEST suite (Political, Economic, Social, and Technological). Can you think of any other reasons why telehealth is soaring? Email me at rahat.haque@aetonixsystems.com. Or let us know on our media channels.
We are Aetonix. We simplify complex healthcare. Full disclosure, we are in Telehealth. But we are involved in Remote Patient Monitoring for those who needed it most, patients suffering from complex needs.
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