Todd Czartoski, MD, Chief Executive Telehealth, Chief Medical Technology Officer, Providence St. Joseph Health
Telehealth has been incubating in the healthcare industry for almost 40 years. Within the past few years it has gathered new momentum, and now, as six current trends come into alignment, the tipping point for telehealth adoption is on the horizon.
1. Telehealth Triumphed in Congress: While politicians battled over the Bipartisan Budget Act of 2018, a massive boon to telehealth slipped under the radar. With the new law, Medicare now covers services like telestroke and telehealth check-ups for dialysis patients regardless of geographic location, and Medicare Advantage plans and Accountable Care Organizations (ACOs) also expanded telehealth coverage. It’s expected that commercial insurance plans will follow suit, signaling a fortunate turn of events for patients, doctors and hospitals.
2. Scaling is a Reality: While some health systems still struggle with making telehealth a boost to the budget, others are demonstrating significant benefits from large-scale adoption. As a multi-state provider, Providence St. Joseph Health (PSJH) spent several years experimenting with financial and delivery models to identify the right way to scale our telehealth portfolio. Today, we have one of the country’s largest enterprise-wide telehealth programs, with capabilities across three service lines in seven states and more than 50 telemedicine initiatives. We have done especially well with tele-ICU, telehospitalists, telestroke, telepsychiatry and Express Care, a direct-to-consumer service. We’ve learned that the keys to successful scaling are a strong value proposition, operational excellence, stakeholder incentive alignment and significant clinician engagement.
"Today, we have one of the country’s largest enterprise-wide telehealth programs, with capabilities across threeservice lines in seven states and more than 50 telemedicine initiatives"
3. Data Interoperability is a Reality: Telehealth gathers lots of data, but the question for years has been, “Where is that data going?” We’re getting smarter. Telehealth advocates recognize that systems don’t work in silos and are focusing on interoperability for better data sharing. We’re working with vendors to aggregate data across ecosystems and then analyzing it with CRM strategies that identify patient and population needs.
4. Telehealth Training Takes Off: It has taken time, but medical and nursing schools are finally introducing telehealth and electronic medical records training that prepare clinicians with 21st-century digital skills. Today’s clinicians are learning how to leverage new tools for improving access, outcomes, safety and the patient experience. They’re also learning how to provide technical help when needed. And they’re paying attention to the nuances of virtual etiquette as well as bedside manner.
5. Partnering With Population Health: Health systems are getting serious about population health, focusing on preventive care, disease management outside the hospital and stretching services across the continuum into ambulatory settings. Telehealth is tailor-made for these strategies. Remote patient monitoring, in-home virtual visits, and tele-behavioral health check-ins all contribute to the population health goal of going deep into communities and keeping people healthier. And with new technology like our Express Care platform, contacting a medical professional on-demand is as easy as ordering Uber.
6. The Push that Mental Wellness Needs: As American society finally opens up about our mental health crisis –now impacting one in five adults–telehealth is ready to help. At our health system, we anticipate telepsychiatry will serve more than 150 sites and approach 100,000 annual encounters by 2022. These services are often a lifeline and significantly reduce emergency department utilization. The biggest challenge? Recruiting enough psychiatrists to fill the need. Some health systems are adopting an integrated model of psychiatrists and allied health professionals to meet the growing demand.
We’re also encouraged to see telehealth innovators taking advice from the most important experts–patients. It is patients, not the hospital CFO or IT consultant, who know how to do it right. Patient feedback points to a consistent preference for virtual visits compared to traditional office, urgent care, or emergency room visits. But our patients want even more, including better online scheduling, more transparency on cost, and on-demand access for a range of specialties. All of these points are valid and feasible and we’re working on it.
With telehealth, we have the tools and expertise to drive more value into U.S. health care. We must use it to shift medicine’s future.