Overcoming 4 Challenges in Implementing Telemedicine, Healthcare's Next Frontier

Unless you have been living under a rock, you know hospitals and health systems are implementing telemedicine programs. Virtual health coaches, web consults with specialists, telemedicine hospital rooms and cloud-based physicians are increasingly common. Telemedicine and telehealth have the potential to increase access to care, improve quality of care and decrease costs.

Hospitals and health systems in rural areas have seen the majority of telemedicine implementation due the needs of the population and area constraints. Travel times, lack of specialty physicians and smaller hospitals witness a vast improvement in quality of care thanks to telemedicine. However, telemedicine could significantly influence the entire healthcare industry in urban, community, international and even global settings.

According to Andrew Watson, MD, a surgeon at the University of Pittsburgh's Medical Center, avid user of telemedicine and vice president of UPMC's International and Commercial Services Division, telemedicine can be used in any location. "Just because telemedicine is different does not mean it is bad, it is the future," says Dr. Watson.

Despite the benefits of increased access to care, quality improvements and cost controls, telemedicine is not simple to implement. There are multiple challenges and barriers that hospitals face.

Here we cover four common challenges to telemedicine and methods to address those challenges.

Challenge one—Administrative engagement
Not every member of the executive or administration team may see the value in the expensive, possibly arduous, process of telemedicine implementation. Since not every patient or every payor is paying for telemedicine services, it is difficult for some hospital or health system executives to see the value proposition, says Dr. Watson. When talking to C-suite executives, it helps if they can see telemedicine value in two ways.

First, they need to understand that the consumer electronics market has already armed physicians with the tools they need. Physicians and patients know how to use cell phones, video chat and text message. "[Many] already communicate in a cloud-based lifestyle," says Dr. Watson. "Individuals have been trained to use [telemedicine tools] through their daily lifestyle."

Secondly, framing telemedicine value in terms of what the hospital stands to gain could be persuasive. A few questions should be answered: Are you getting more cases for your specialists? Are you decreasing readmission rates? Are you building a team of specialists? According to Dr. Watson, if the answers are yes — and they should be — those implications may prove useful for branding the hospital and promoting its reputation, thus, increasing telemedicine's ROI.

Challenge two—Physician engagement
While it may be that physicians use consumer electronics in their personal lives, they may not want to incorporate technology into their practice. There could be a variety of reasons a physician would be reluctant to use telemedicine, says Arun Ravi, senior consultant, healthcare group, North America at Frost & Sullivan. They may not want to be dependent on technology, they may be overworked or they merely do not want to train on the equipment. Additionally, if a physician has patients to see and the technology breaks down, they cannot rely on the equipment to continue treatments and patient consults, says Mr. Ravi. "A dropped connection may not be a huge deal between friends but between a physician and a patient — it could lead to missed instructions and possible patient mismanagement," says Mr. Ravi. Beyond waiting for a younger physician population — already trained in telemedicine technology — to graduate from medical school, there are certain ways to approach physician telemedicine engagement.

One way to address the issue is to remind physicians that telemedicine is bringing medicine back to its roots, back to the communities and back to individual houses. "Remind physicians that telemedicine aids population healthcare," says Dr. Watson. "Telemedicine is what the patient wants; it is the future of healthcare. That should speak to physicians."

Challenge three—Infrastructure
Concerns surrounding the infrastructure of telemedicine for a hospital are justly founded. No physician wants to deal with a malpractice lawsuit after a disconnected virtual consult leads a patient to follow the wrong treatment regimen. Dr. Watson recommends strong platforms for scheduling people, locations and devices to address infrastructure issues. If possible, state-of-the-art platforms are best. "When you purchase a car you can select the options of cruise control or heated seats. With telemedicine, you have options to buy necessary technology that can sustain your telemedicine needs. That technology is a strong platform and internet connection and it is necessary," says Dr. Watson.

Ross Hurd, chief information officer at Lake Chelan (Wash.) Community Hospital, which has implemented a vast and successful telemedicine program, agrees telemedicine implementation needs to have stable internet connection. "Once you have that, you should run applications across the internet to train hospital staff and iron out any problems." Even if the telemedicine infrastructure is strong, problems can still occur. Test-runs are vital to prepare hospital staff and ensure they are comfortable running the technology.

Challenge four—Sustainability
Issues with sustainability derive from whether a hospital will be able to maintain telemedicine services once implemented. The biggest issue with telemedicine is whether it will be reimbursed by payors, says Mr. Ravi. The best way to address that is to demonstrate value to the payors.

According to Dr. Watson, a method for guaranteeing the value of a telemedicine program, talk with those who have experience. "Understand what telemedicine does and how it works," says Dr. Watson. "If you have a great example to follow, buy-in from all levels of the hospital is easier and the telemedicine is more likely to be successful and demonstrate that needed value." Discussing implementation processes with successful telemedicine practitioners is a best practice that could determine the difference between a sustainable program and a failed program.

Although there are challenges to successful telemedicine implementation, the benefits technology holds for the healthcare industry are well worth the time and effort. "The aging baby boomers will soon place a strain on the medical community", says Mr. Ravi. "There are only so many geriatric physicians available."

Telemedicine can help physicians consult and treat patients miles away. Telemedicine can help hospitals offer specialists that do not live or work in the area. Telemedicine can transcend physical limits to offer better access to better care. According to Dr. Watson, "Telemedicine is the future of the healthcare industry and the sooner hospitals address the challenges, the sooner they may reap the benefits."

Related Articles on Telemedicine:

5 Common Telemedicine Mistakes to Avoid
St. Luke's Hospital of Kansas City Uses HIT to Help Patients Navigate Facility
New HIT Toolkit Targets Rural Health Providers

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