“We call it telehealth now, but in five years, we’ll just call it health.”
So said Anthem’s John Jesser, speaking at New York City Health Business Leaders panel last week. The upshot: telemedicine is coming soon to a screen near you, and it might turn American medicine upside down.
“The anchor is urgent care,” said Jesser, who heads provider engagement strategy at the insurer. “You can be face-to-face with a board-certified doctor 24/7, and they can write a prescription and send it to the pharmacy electronically. That’s the ‘Ah-hah’ that’s creeping across the category.”
While CMS has dawdled on reimbursement for telemedicine, private insurers and employers seem to be stepping up, motivated in part by the drive to realize cost savings through a better patient experience and greater adherence, which beget improved patient outcomes. Anthem has more than 500 large employers (and thousands of smaller ones) enrolled in its LiveHealth Online video chat service.
“Revenue models have varied, but the toothpaste is out of the tube on this,” said Jesser. “We ended up eating the cost, knowing that over time it will pay off.”
Children’s Health Fund Chief Medical Officer Dr. Delaney Gracy offered one example of how it might pay off. The CHF and the University of Miami instituted a telehealth pilot to service high-needs rural patients with specialty care, adding telehealth services to a well-established primary care mobile medical clinic, and saw a massive improvement in adherence to specialty care appointments when using telehealth – from 34% to 94%. Together with Chiricahua Community Health Centers, they are now adapting this mobile clinic-telehealth model to serve pediatric patients in Southern Arizona.
Northwell (nee North Shore-LIJ) Health System has implemented a “tele-ICU” for patients requiring a high level of isolation at their Long Island facility, using video visits to supplement in-person ones without the risk of contamination, said the system’s telehealth head, Iris Berman, RN, MSN, CCRN. Northwell plans to expand the program to neurosurgical services, pediatrics and cardiac care next.
Telemedicine also promises to deliver a better customer experience, saving cost-crunched patients money as well as time and delivering the kind of frictionless electronic experiences that consumers have come to expect from online retailers and, increasingly, healthcare companies (fun fact: 59% of online consumers expect healthcare companies to deliver the same level of customer service they get on Amazon.com, according to DRG’s CyberCitizen Health® U.S. 2015 study). And the cost to employers is negligible relative to the cost of providing employees health insurance, said Wells Fargo’s Brian Woods.
Barriers remain. Among them: Interoperability within the payer system; High-speed broadband access, especially in rural areas; resistance from providers; and state licensing laws that couldn’t have anticipated a global information superhighway.
“What’s clear from the panel is that we need to educate consumers and physicians about the benefits and appropriate use of telemedicine,” said NYC Health Business Leaders President Bunny Ellerin, “as well as the times when an in-person visit is needed.”
Regardless, says Anthem’s Jesser, “In the next couple of years, you won’t be able to remember a not being able to connect with your physician through an electronic device.”