The use of technology in the health care vertical is expanding on an exponential level, and while telehealth may have started on a slow march, it is now considered to be one of the most cost-effective ways to expand patient care access and deliver health care services. Making use of such technologies as remote monitoring, videoconferencing, wireless communications and electronic consults, telehealth addresses one of the most sensitive problems by allowing the patient’s health care team to increase patient care.
Physician and specialist access is difficult for a variety of patients that cannot go to treatment locations. Telehealth offers the type of connection for patient communication with doctors, allowing a state of immediacy for their care. This is especially important for patients that are not ambulatory or have little or no commuting access. Previous treatment for these patients required in-person/face-to-face visits which elevate costs. While private payers have adopted a more accepting attitude towards telehealth, government programs have been slower to move forward. This is changing as the data is coming forward to demonstrate that telehealth is offering high quality care and reducing the costs associated with adverse medical conditions and readmissions. The 2016 Medicare Payment Advisory Commission (MedPAC) included the recommendation of telehealth in their guidelines for coverage, noting the benefits and expression of concern that telehealth services may be moving too slowly in the Medicare programs.
One of the best examples of telehealth success has been in the Veterans Health Administration (VHA). They introduced programs involving telehealth in the 90’s and have been one of the pioneers of these programs in the U.S. The VHA uses a multilayer approach with telehealth for the provision of targeted care management to veterans with diabetes, hypertension, congestive heart failure, post-traumatic stress disorder, chronic obstructive pulmonary disease and depression as well as providing routine care. The savings over the years have been a benchmark, showing a 25 percent reduction in the number of hospital bed days and a 19 percent reduction in readmissions in VHA hospitals. Telehealth has demonstrated an overall savings of nearing $1 billion in 2012 alone.
Hospitals are using telehealth as a method of treatment for patients whose illnesses are severe enough that they would normally be in a hospital environment but are stable enough for home treatment. These “stay at home” models are being pioneered at such locations as John Hopkins Medicine in Baltimore, MD, where elderly patients may refuse a hospital stay or have immune systems that are compromised, making them more susceptible to acquired infections in a health care environment. Making use of telehealth brought the in-home care needed by the patient while reducing the rate of complications from 24% to 9% and a 19% reduction in overall costs as compared to an in-hospital stay. The additional benefit for the patient using telehealth includes shorter length of stay and reduced clinical testing.
Telehealth is currently being adopted by a number of medical health verticals and the investment in telehealth is continuing on a greater scale. Both retail clinics and private insurers are adding telehealth to their private and Medicare coverage. CVS Health added three telehealth companies in 2015 for the expansion of patient access to physicians and online in a pilot program. The results of this 18-month experiment included a survey that indicated 95% of the patients were not only satisfied with the quality of care and ease of use, but an additional one-third stated that they preferred telehealth to a clinician visit. As the use of telehealth continues to advance, it appears that it is meeting the needs of the patients while assisting in the reduction of medical health care costs.