Fact or fiction: Top 6 telehealth myths to know

The number of health systems adopting telehealth programs is on pace to double in the next few years as a result of the shift to consumer-driven healthcare, which has been expedited by policy changes and technology advancements.

While the rapid growth of virtual healthcare has improved access to care for many patients, it simultaneously caused many common misconceptions about telehealth to emerge.

In a Feb. 26 webinar sponsored by American Well and hosted by Becker's Hospital Review, Roy Schoenberg, MD, president, CEO and co-founder of American Well, helped separate fact from fiction by discussing 12 telehealth myths for health system executives to know.

"Despite the incredible enthusiasm around telehealth … the proliferation of knowledge on how telehealth can serve the [healthcare] industry has been lagging behind the sparkly object, which is the video conferencing," Dr. Schoenberg said "As a result, organizations … have been finding themselves in places of disappointment."

Here are six of the 12 misunderstandings addressed in the webinar to help hospital executives meet their telehealth goals.

Myth 1: Telehealth is just an on-demand consumer service (for flu, rash and runny nose).

Due to the virtual nature of a video-based care visit, people may believe telehealth can only be used for primary or basic care services. While telehealth is commonly used to provide urgent-care-like services, the reality is the technology behind telehealth is at the core of two other broad applications, including follow-up care between providers and patients, as well as provider-to-provider consults.

"Clinicians or provider organizations are using this technology for follow-up care … because they are responsible for the well-being of their patients even when their patient is not in front of them," Dr. Schoenberg said.

In addition, telehealth can connect providers to other providers to ensure patients have access to a properly skilled physician for their case.

Myth 2: Telehealth ROI equals patient volume multiplied by the cash margin.

The popular return-on-investment formula for telehealth multiplies patient visits by the cash margin. This common analysis shows that an urgent care visit generates a $15 to $20 margin per visit, which means providers must see 2,000 patients via the technology to break even and cover the costs of the telehealth program.

However, when a health system utilizes the broader applications of telehealth, such as implementing follow-up care technology to prevent readmissions or using inter-provider consults, the number of patients needed to break even changes to just two. 

Myth 3: I can buy the technology, enroll my physicians on it, and roll it out to the public.

"The reality is most health systems have their physicians operating at a relatively high level of efficiency," Dr. Schoenberg said. "When you talk about [relative value units], most of your clinicians don't have the cycles to begin offering telehealth, especially not urgent care, which is a relatively small-level transaction."

To address this challenge, health systems are using clinicians from the telehealth infrastructure vendor they worked with to implement the program.

In the first and second year of telehealth implementation, many health systems rely on an external network to staff the service. Around the third year of a telehealth program, health systems begin to reduce their reliance on the external network and start to use their own clinicians.  

Myth 4: Traditional marketing will get the message out about telehealth.

In the U.S., healthcare marketing is very local. Marketing telehealth is fundamentally different from local marketing because it has a primarily digital audience.

"Digital marketing is much more ferocious [than local advertising]," Dr. Schoenberg said. "There has to be a constant feedback loop that allows the telehealth product to sense where patients are coming from, correlate that with which digital channels you invested in, and then on the fly adjust your dollar spending to optimize your marketing dollars … that is a technology built into some telehealth products."

Automated digital marketing strategies can reduce the amount of marketing cost per telehealth visit generated from as much as $250 per visit down to 50 cents per visit.

Myth 5: Healthcare organizations know their telehealth competition.

For many years, it was true that a provider's main competition was other local healthcare organizations with a physical footprint in the area. However, when it comes to telehealth, this has changed.

"As you look at your territory, because all of these services are coming online, a lot of other organizations that don't have any physical footprint in the environment may be overlapping with you,"  said Dr. Schoenberg  "This means your telehealth services have to be competitive against … [even more] brands.".

Myth 6: You can simply submit claims and get paid.

Due to the rapid evolution of telehealth and the various policy changes, there is incredible diversity in how claims are being paid and processed for telehealth services. Providers cannot just submit a regular claim and expect to be reimbursed accordingly.

"Sometimes there is an out-of-pocket contribution that is different for telehealth than a regular office visit," Dr. Schoenberg said. "In some cases, the claim has to be submitted with different headers or footers for a payer to inspect and interpret the claim. … Sometimes providers need to fall into a specific network, otherwise it will not get paid." .

To ensure maximum reimbursement and lessen the risk of claim denials, a telehealth program must have the flexibility to handle every transaction and claim process.

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