Kristin Darby, CIO, Cancer Treatment Centers of America
Telemedicine is a rapidly growing method of care delivery. Consumers now have an option to access a provider at their convenience virtually for many common health care conditions. As the health care industry shifts to value-based care, additional virtual care offerings under the broader umbrella of telehealth are being offered, which include wellness through sick care.
"As consumer behavior and expectations for on-demand services at the time and location of their preference transfer to health care, we expect to see telemedicine and mobile health offerings grow"
If we step outside of health care for a moment, we can acknowledge significant shifts that have taken place in our environment. With the launch of the Apple smartphone in 2007, Americans have quickly adopted mobile connectivity as a primary means for obtaining information, performing daily tasks, and becoming increasingly empowered consumers. Pew Research estimated in 2017 that smartphones are owned by 77 percent of adult Americans, which has had an impact on the culture of American society regarding communication preferences, social interactions, and approaches for navigating daily tasks and important life events such as health care. Pew Research Center reported in 2015 that more than 62 percent of smartphone users have used their phone to look up information about a health condition.
Mobile devices, the internet, and Google have also completely transformed our expectations around the availability of information: when we have a question today, most of us immediately “Google it.” Growing up, I would write the question down and either visit the school library or look it up in an encyclopedia, which was likely a few years old since printing. I remember my parents saying those encyclopedias would be an asset I could pass on to my children for their studies. Clearly they could not predict the disruption that the accessibility and mobility of the internet would have on all our lives.
As we think about these environmental shifts within the context of health care, it is often acknowledged that our industry lags technology adoption trends. When you visit hospital providers or physician offices, the processes and procedures are typically organized around silo administrative functions and areas of clinical specialty. In addition, patients often spend a significant amount of their time traveling to different locations or visiting diagnostic clinics based on provider availability rather than patient preference.
Virtual care has the potential to transform the patient experience across all areas of care. Providers struggle to piece together all the care access and supportive therapies, and services that patients need along their care journey. When telemedicine is combined with other services or remote monitoring devices, it enables a consumer driven experience where an overall service offering can be personalized based on an individual patient’s requirements, and the type of experience they value. In a time of digital advancement, we find that many new offerings are returning to a house-call model. As consumer behavior and expectations for on-demand services at the time and location of their preference transfer to health care, we expect to see telemedicine and mobile health offerings grow. The physician performing a house call today has access to many tools via their smart phone to perform comprehensive patient examinations. Insurance coverage continues to be limited, however, and there is no reimbursement parity across states, resulting in limited access for many patients.
The following are some shifts that health care providers should consider to ensure their organizations are embracing a consumer-centric approach to telemedicine offerings:
• Mhealth: Mobile Health provides options for around-the-clock patient health care monitoring. When mobile devices such as smart phones and wearables are used, it enables real-time, proactive alerting and triage of issues versus reactive care. This can then be combined with telemedicine when intervention is needed.
• Preventive vs Reactive: Current state sick care will continue to move to preventive well care as population health models mature.
• Scheduling: Consumers are driving a shift to a more patient-focused, convenient experience where appointments are being scheduled around the patient rather than the provider.
• Economics: As consumers bear more of their health care cost, they are demanding increased transparency around price and the financial implications of care decisions.
• Quality: As patients become more empowered health care consumers, they are educating themselves about quality of care variations between providers and facilities. This will play an increasingly important role in a patient’s decision around the overall value of the care they select.
• Consumer Ratings: Provider ratings systems will become increasingly important to patients when deciding who to select for care.
• Data Ownership: Empowered patients will begin to take greater ownership of their medical records. In the same manner as they do in their normal lives, patients expect to easily exchange and aggregate clinical information during their care journey. This is reinforced by millennials who have embraced data sharing among social platforms to promote wellness and awareness around health conditions.
Telemedicine is on a trajectory to become a large portion of patient and provider interaction. As technology continues to be more integrated into our daily lives, I predict we will see an acceptance of telemedicine to the extent that it becomes a normal format for a doctor visit. The physical versus digital method of access will become irrelevant in all but the types of care that require physical contact. Telemedicine provides consumers choice and convenience, the embodiment of a consumer-centric care offering.
Courtney Fisher-Lewis, Associate CIO, Saint Luke’s Health System & Ex-Sr. Director, IS Program Management, Children’s Mercy Hospital David Chou, SVP & CIO, Harris Health System & Ex-Chief Information & Digital Officer, Children’s Mercy Hospital