Telemedicine in 2016: Consumerized and more highly utilized

While telemedicine itself isn't new, the ways in which hospitals, providers and patients are utilizing this technology is transforming alongside shifting healthcareare models. Telemedicine is turning into a direct-to-consumer service, and more and more service lines in hospitals are offering their patients tele-consultations.

These trends are expected to continue into 2016 and beyond as telemedicine becomes a normalized healthcare offering. Here, Steve McGraw, president and CEO of telemedicine and telestroke provider REACH Health, shared his insights on what the healthcare industry can expect from telemedicine next year.

Editor's note: This interview has been lightly edited for length and clarity.

Question: As we look forward to 2016, what is the biggest telemedicine trend you anticipate?

Steve McGraw: By far, the biggest trend that we'll see next year is the consumerization of telemedicine technology. The technology behind telemedicine programs will look a lot more like what we see with consumer electronics — platform-based, compatible with multiple devices, flexible and easy to use. Just as single-function phones have been rendered obsolete by multipurpose smartphones, software-based platforms will replace telemedicine systems based on proprietary hardware and networks. Software-based telemedicine technology will be leveraged by hospitals and health systems to support multiple service lines and a variety of delivery models across the continuum of care.

Q: Can you comment on the decline of proprietary hardware? Why are we seeing this?

SM: A growing number of providers are becoming telemedicine-savvy and recognizing its full potential. While proprietary hardware was commonplace for early telemedicine technologies, it is not affordable or flexible enough to meet the broadening needs of patients and healthcare providers. Telemedicine hardware is a commodity, and it's an obvious place to reduce expense in order to make telemedicine even more cost-effective. It simply doesn't make financial sense to have costly, closed-devices that only support a limited range of functions. Off-the-shelf PC components and emerging open network standards will let providers choose the most appropriate endpoints for their clinical needs — whether they be high-performance carts, PCs or mobile devices such as tablets.

Q: It seems like most telemedicine platforms, those that are consumer-facing at least, are all apps that can be used on smartphones or computers. Where is the balance between these apps and clinician-to-clinician platforms?

SM: Regarding the apps for clinician-to-patient, most are pretty rudimentary: They facilitate e-visits, collect patient data such as blood pressure or provide medication reminders. This is great for patient convenience,for reinforcing healthy behaviors and medication compliance, but it's a very small piece of the telemedicine puzzle.

Telemedicine is also about bringing specialty care to underserved regions, reducing patient transfers, intervening earlier, leveraging existing physician resources to support ICUs and acute care environments and achieving other goals relevant to different care settings. Telemedicine is a key strategy in healthcare's triple aim.

Q: Where does the industry currently stand in terms of telemedicine adoption? Would you say it is widely adopted?

SM: REACH Health interviews hundreds of healthcare executives, physicians and nurses about their telemedicine priorities, goals and challenges and compiles the findings in the annual "U.S. Telemedicine Industry Benchmark Survey." Our 2015 survey indicated the telemedicine industry is quickly maturing, with nearly 60 percent of respondents noting telemedicine as one of their top priorities. And while high-acuity settings that offer more specialized treatment also have a higher degree of telemedicine maturity, respondents indicated they were actively planning to bring telemedicine to lower-acuity settings as well. So, for example, about 65 percent of our respondents had active acute care telemedicine programs, compared to about 19 percent who were using telemedicine for general practice.

There is also significant variance between different service lines and specialties. While more than 60 percent of our respondents indicated they had a telestroke program, less than 30 percent used telemedicine for pediatrics. What we've observed over time is that telemedicine was born out of necessity — in our case, providing faster treatment to rural stroke patients — but has grown for utility. Given factors such as the large aging population and shortages of medical specialists in multiple geographies, I'd suggest that necessity is still a relevant driver.

Q: Where would you like to see telemedicine utilization progress? What is your ideal vision of telemedicine in U.S. healthcare?

SM: The healthcare industry and healthcare consumers will experience the full benefits of telemedicine once it is in use in all service lines and across all settings of care.

We are seeing some of the nation's largest health systems start to expand their telemedicine programs across service lines. For example, many begin by using telemedicine in their neurology departments and ERs for stroke consults and treatments. Once that service line is up and running — and the benefits are clear — they are expanding it to other areas, including pulmonology, psychiatry and cardiology, just to name a few.

Telemedicine must extend outside the four walls of the hospital. To ensure optimal patient follow up care and vastly reduce readmissions, hospitals are partnering with other healthcare providers (nursing homes, rehabilitation, physical therapists, etc.) to bring the benefits of telemedicine to wherever the patient is physically located.

For telemedicine to reach its full potential, complimentary medical technology will play a key role. Here I'm referring to things such as seamless EMR integration, portable or wearable sensors that quickly capture patient vitals, robust consumer apps that help patients manage chronic diseases, and others. All these technologies will need to communicate with one another.

Q: Are providers and patients satisfied with the current telemedicine technology and capabilities?

SM: The results that many of our customers have experienced are impressive: hub hospitals and their spoke partners are able to treat more patients, more quickly and significantly reduce timely and costly transfers. Our customers have also shared that patients are overwhelmingly pleased with the use of telemedicine. While talking to a doctor via a computer screen may be initially unfamiliar, patients are seeing the value of quick, efficient treatment and the ability to be treated at their local hospital, close to their loved ones.

One of the biggest demands we've observed in the industry is for EMR integration. Since most telemedicine networks include providers using different EMR systems, it has, at times, been a challenge to get that information to flow freely. During a telemedicine consultation, relevant patient information needs to be presented seamlessly to both the clinician at the point of care and the remote specialist — even when they use different EMR systems. As telemedicine has grown throughout the continuum of care, integration with EMR systems has quickly become a baseline expectation.

Hospitals also want technology that can simultaneously adhere to protocols while accommodating user preferences. As an example, a widely used program such as Microsoft Outlook, facilitates important enterprise functions such as sharing calendars, but it also gives individual users the ability to configure the display, set reminders, etc. I see telemedicine evolving in a similar direction.

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