The future of telehealth: 4 questions with Teladoc's Dr. Alan Roga

Alan Roga, MD, has a jam-packed resume. Trained as an emergency medicine physician, he's a fellow of the American College of Emergency Medicine and has been recognized multiple times as Phoenix Magazine's "Top Doctor" in emergency medicine. In 2009, he founded StatDoctors, which was acquired by Teladoc in June 2015. With the acquisition, Dr. Roga serves as president of Teladoc's provider market division.

Purchase, N.Y.-based Teladoc, which has been operational since 2005 and went public in July 2015, is the first provider of telehealth medical visits in the U.S. Servicing employers, insurance carriers and hospital systems, with 15.4 million members and more than 1.6 million visits since its inception, the company works to tackle three of the largest issues in healthcare: access, cost and quality. Teladoc has also developed a four-step readiness assessment tool — whose framework involves organizational, use cases, operational and solution set steps — to help hospitals and health systems find the best way of creating a telehealth roadmap.Alan Roga Headshot

Dr. Roga, a thought leader, has also written about the future of telehealth and spoken about the best way to integrate a telehealth strategy. Here, Dr. Roga discussed Teladoc's readiness assessment, what sets Teladoc apart and where telehealth is headed.

Question: What sets Teladoc apart from other telehealth providers?

Dr. Alan Roga: We are the only one of the modern day telehealth companies that are public. With this comes extensive transparency on our company operations, metrics and third party validation on the value we provide to clients. Additionally, we currently have about 70 percent of the market share, and we've done significantly more visits than anyone else in the telehealth space. There are three ways in which Teladoc sets itself apart.

First, when it comes to the provider space, Teladoc is only one of the major vendors that has a dedicated business unit that focuses exclusively on hospital and health systems. Although we're a larger telehealth company, the fact that we have a dedicated team allows us to have specific subject matter expertise in the provider market, serve our clients better and be nimble in technology and operational development.

The second big bucket is regarding our ability to support our clients in three main areas: marketing, operations and provider network. We provide unmatched marketing and consumer engagement resources and pretty much every piece of material a client can request. We are the only one of the telehealth companies that has completely insourced their consumer touch points from end to end. This is accomplished through our 75,000-square-foot operations center in Dallas. Every time a patient interacts with us through our operations center, it's with a Teladoc employee. This allows us to provide superior care and better oversight of our quality programs. Finally, we have over 3,100 providers in our network, to support our hospital's programs to the degree they request.

The third major area is our technology, which is not only cloud-based but also cloud architected technology. The result is greater reliability and configurability of the client's instance, providing confidence in the platform and decreased overall fees

Q: Why did you develop your readiness assessment tool and what do you see as the primary benefits of the readiness assessment as opposed to other methods of developing a telehealth strategy?

AR: The telehealth market began in the employer space. It migrated to insurance and is now in the hospital space because the financial risk has been shifted. Seventy percent of large employers have or will be implementing telehealth by 2017.

Hospitals realize they're going to be doing telehealth, but what I find is that most of them question how to start. An easy trap is to only look at the technology aspect. But technology is just the tip of the iceberg. Ninety percent of a successful telehealth strategy involves people, processes and operational support. Telehealth is a delivery system. Hospital partners would often come to us with a use case. They were either responding to a competitive force in the marketplace or they were increasing their financial risk exposure, but they hadn't necessarily thought through the strategy of a telehealth program.

We had to develop a tool to help providers know where to start. The No. 1 mistake I see among providers is not aligning their telehealth strategy with their organizational goals. The No. 2 mistake I see is that organizations underestimate their operational support needs. They'll quickly want to change their brick and mortar delivery to telehealth. Our tool takes organizations through a planning process. It starts with organizational alignment, then evaluates use cases, addresses operational needs, and ends up with solution sets. We then develop a multi-year plan for the hospital.

Our readiness assessment helps providers align their telehealth initiatives with their organizational goals. What we find at the end of the day is that we have happier clients with more effective programs and yielding better results.

Q: What is one word or phrase you think we should use more in healthcare?

AR: Without question, value. I believe that not only for telehealth but also for healthcare in general, we haven't necessarily thought of the programs and procedures from a value decision-making matrix. There has to be value creation in everything.

To me, the current value of telehealth lies in three main areas: finance, care coordination and growth strategies. From a financial perspective, this is an ROI-driven value creation discussion. When we look at care coordination, the value is around efficiency. Regarding growth strategies, the value is on increased market share and improved patient retention.

When we approach telehealth in the hospital space, we make sure there is a substantial understanding of the value in the telehealth program.

Q: What do you see as the future of telehealth, and how will Teladoc adapt to meet these changes head-on?

AR: I think we will see sub-specialty care being provided. The next market demand is for behavioral health. Dermatology is also where the market is headed. After that, cardiology and orthopedics for post-op care are the next logical ones.

Another big rock that the industry will need to address is around data integration. First thing to solve for is to simply share the data, and I think we're doing a decent job at it now. But now we have to find ways of making the data consumable and actionable.

Finally, the industry is headed is from acute care to longitudinal and more complex care. We started with acute general care which we are doing very well with. Adding in specialty care, peripheral devise and then sharing data all moves us towards that path.

Teladoc’s telehealth technology platform and licensable software solution has earned the exclusive endorsement of the American Hospital Association.

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