The healthcare industry seems aligned in the belief that now really is the time for telemedicine to take hold in the provider-to-patient realm.
The past decade has seen advancements in technology, healthcare legislation, and consumer behavior that have set the stage for a new model in medical care. Hospitals and physicians have migrated to electronic medical records and created patient portals. Further, legislation at the national and state levels, while still a barrier, has evolved to provide better compensation for remote care. And finally, consumers have grown increasingly dependent on personal technology to make daily tasks faster and more convenient. As consumers grow more and more accustomed to speed and access, their expectations will extend to how they access healthcare. But to take full advantage of these trends, one must take a page out of the retail playbook.
First, let’s drill down a bit more into telemedicine. The technology trend can be viewed in three segments. The first and most evolved to-date is Provider-to-Provider telemedicine. Examples of success in this segment can be found in the application of ICU stroke care. Mercy Hospital’s Virtual Care Center provides remote consults and monitoring to 33 hospitals across four states, allowing highly specialized care to be delivered quickly and effectively without the danger of sending a patient to a centralized hospital when time matters.
The second segment of telemedicine, involving remote patient monitoring, is exciting for its potential scale and ability to impact the daily lives of patients. Measurement and tracking all types of personal health information has exploded with smart phone apps and wearable devices. Market research firm Berg Insight estimates that the number of remotely monitored patients, let alone everyday consumers, will exceed 50 million in the next four years.
Consumers have tools to gain awareness of their physical activity, sleep patterns, dietary intake, and more. While there are many successful efforts to manage conditions from diabetes to hypertension remotely, the challenge remains in integrating and leveraging these data to impact long-term health and care delivery at a larger scale.
In the third segment, Patient-to-Provider, success depends on meeting the needs of the patient as a “consumer.” Moving from being always in the room with the healthcare provider to phone, video, or other digital means may be a logical, natural evolution for younger patients.
After all, this is a population who goes first to Google when they don’t feel well. They expect to be able to make and manage appointments, pay bills, and access their medical information online, where and when they want. As this generation becomes adults and caregivers, they are bringing their expectations for convenience and a consumer mindset to their healthcare experiences. While younger consumers have fewer medical visits, many will grow up to form busy families for whom convenience will be critical.
Telemedicine also holds appeal for older populations, as evidenced by a Mayo Clinic study that reported that nearly two-thirds of older urologic patients (average age 58) were “very” or “somewhat likely” to engage in a video visit with their provider.
Consumer satisfaction has been high with telemedicine. A study by Rock Health of users shows that adoption has been highest to-date in phone-based visits (59 percent), but that satisfaction is highest in live video interactions (83 percent satisfaction), a growing segment. Patients at CVS’ Minute Clinic who opted for a telehealth visit to avoid a wait to see a provider reported 94-99 percent satisfaction and a third of them reported a preference for telehealth over an in-person visit.
Employers have been enthusiastic adopters of telemedicine, seeing it as a cost-effective way to keep employees happy, healthy and at work. According to the National Business Group on Health, in 2016 70 percent of large employers offered telehealth services in states where it is allowed. It’s expected that this number will jump to 90 percent this year.
So why, despite the successes, does telemedicine’s uptake in the patient-to-provider realm still lag industry expectations?
Several factors seem to hamper adoption. Reimbursement is not yet universal, but consumers are growing used to paying more out-of-pocket with high-deductible plans. Physicians have long resisted change in how they practice, and many remain lukewarm at best about telemedicine. It’s no coincidence that many of the innovations and pioneering models have come from outside of healthcare delivery. Now, IDNs (integrated delivery networks) are turning to companies like Zipnosis and American Well for telemedicine solutions. The barriers that loom the largest may likely be consumer awareness and trial.
Getting consumers to adopt telemedicine will come down to smart marketing, based on understanding consumers and their relationship to their health decisions and preferences. Offering video or phone visits is not enough. A report by athenahealth found that patient portal adoption rate is only 29 percent on average among its universe of 7.5 million patients. (Link) Getting patients to leverage telemedicine will require building awareness at the times and places that they are ready and willing to engage.
IDNs are spending millions of dollars implementing telemedicine solutions for basic sick care in the hopes that the service will attract new patients and increase engagement and satisfaction among existing patients. Building awareness of the offering is expensive. To succeed, IDNs should study the marketing efforts of retailers.
Look at CVS and how they are using the problem of patients waiting in line at Minute Clinic to introduce a faster option with telemedicine. Southwest Medical in Las Vegas introduced the option of NowCare e-visits on its website, next to the current wait times by clinic. Look at how retailers, like Walmart, integrate online shopping and the store experience by offering side-by-side options supporting product delivery and in-store pickup. Telemedicine options ultimately need to be offered in a way that feels integrated and seamless to the health consumer.
Healthcare delivery networks need to incorporate patient location more directly when delivering care. Is there an easy link to a virtual visit from your urgent care web pages? Are IDNs leveraging all your pediatric and maternity touch points to engage new families whose demand for convenience is increasing rapidly?
Consumer-centric telemedicine as a business model still has detractors. When the provider is left waiting for patients to call them, financial profit is less assured. However, wise health organizations should view telemedicine as part of their entire ecosystem. It can be an important tool for engagement, satisfaction, and attracting new patients. Furthermore, it can provide a laboratory for better understanding patients as consumers, which will ultimately be necessary for health systems to succeed in serving future generations.