Making the telehealth puzzle piece fit in your organization: Thoughts from 3 executives

Employers and patients have grown more accepting of telehealth in recent years. For instance, 70 percent of employers plan to offer telemedicine services as an employee benefit by 2017, and 65 percent of Americans in 2015 said they would attend a clinical appointment via telehealth.  

While the virtual care setting gains familiarity, many hospitals and health systems are left to strategize about how to best incorporate the capability into their clinical offerings. At the 5th Annual Becker's Hospital Review CEO + CFO Roundtable, two health system CFOs touched on the decisions they face about telehealth and the CMO of a major telehealth company weighed in with his observations, as well.

Shelly Hunter is CFO Mercy SW Missouri-Kansas, based in Joplin, Mo. So far, the system has telehealth capabilities for stroke care, e-acute care to assist hospitalists and an e-ICU for its larger hospitals, the last of which is available around the clock.

Going forward, Ms. Hunter said the system sees value in partnering with a telehealth provider rather than trying to build this capability organically, specifically for primary care. Furthermore, changing demographics in the U.S. underscore the value of telehealth, she noted.

"We don't have enough primary care physicians," said Ms. Hunter. "We looked at partnering and will probably partner with a telehalth primary care organization — I believe that will come sooner rather than later. Millennials are outpacing baby boomers, and I know convenience and access is their No. 1 concern."

Greg Klugherz, senior vice president and CFO of CentraCare Health in St. Cloud, Minn., said his organization is learning how to complement its existing clinical services with telehealth. The system includes a medical staff of 400 physicians and advanced practitioners. "We need to celebrate the reality that telehealth makes access available to us that otherwise wouldn't be," said Mr. Klugherz. "We haven't gone very far down the telehealth road, but are conscious of the need to."

In addition to business decisions, adding telehealth requires cultural considerations. Namely: How does a hospital tack on telehealth capabilities without alienating the existing medical staff?

It's critical for hospital leadership to help their physicians view telehealth as a complementary service that creates a new channel of access for patients — not a competing force stealing patients.

In fact, of patients who use telehealth services, Peter Antall, MD, chief medical officer of American Well, says less than a third of them would have visited a primary care physician for the same ailment. Boston-based American Well has partnered with approximately 40 health systems across the country for telehealth services.

"The vast majority of people go to a retail clinic or urgent care when they have a condition," he says. "Telehealth really can be a complementary service. We get occasional pushback from primary care physicians, but by and large they are focused on their most critical patients." Dr. Antall says PCPs are often happy to offload low-acuity visits as long as they have interoperability to understand what's happening to those patients during their telehealth encounters.

Dr. Antall also noted how physicians who treat patients via telehealth are uniquely positioned to achieve work-life balance. "We saw early an opportunity to offer improved work-life balance in telehealth," he said. "Most physicians are in a home office." Whether it's the older physician who is nearing retirement but still wants to be engaged with patients or the younger physician with young children, many physicians and personalities find the flexibility of telehealth attractive.

Now, American Well is devoting more time and attention to creating "virtual water coolers" for these physicians. Although they work remotely and may enjoy the benefits that come with it, the telehealth company still wants to create a sense of community and morale among its medical staff — just as any hospital or health system CMO strives to do.

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