Alan Roga, MD, president of health systems for Teladoc Health, led a discussion about consumer telehealth strategy during an executive roundtable at the Becker's Hospital Review 10th Annual Meeting in Chicago in April. The discussion was driven by results from Teladoc's 2019 State of Consumer Telehealth Benchmark Survey, which highlights the types of providers driving growth in consumer telehealth services, why they are expanding and how they are doing so.
Teladoc Health is the global leader in virtual care delivery, and leading telehealth provider in the U.S. In 2018, Teladoc facilitated 2.5 million patient visits by mobile, internet or phone. Dr. Roga said the company anticipates more than 3 million visits in 2019. Teladoc Health is a proud partner to 12,000 clients including more than 300 health system clients; one of the fastest growing segments in virtual care delivery.
"Our philosophy is virtual first. Can the first touchpoint with the patient be virtual, then we direct them to in-person visits as appropriate? Sometimes it's definitively treated, and sometimes the patient needs additional care." Dr. Roga noted.
Past the point of inevitability
For each of the past three years, Teladoc Health has discerned a theme from the results of its Annual State of Consumer Telehealth Benchmark Survey. "The theme this year is that mainstream adoption of virtual care is past the point of inevitability," Dr. Roga said.
He noted that employers were the early adopters of telehealth services roughly nine years ago, with insurance carriers following after seeing employers' results. "Health systems really started adopting in the last four years," Dr. Roga said. "This is not a question of if you're going to adopt telehealth, it's a question of when. That's just the reality of what the consumer wants and what the market expects."
10 key survey results
The survey drew responses from more than 300 health systems executives and telehealth leaders; 68 percent of whom are executives or directors/managers and 88 percent of whom are from health systems or short-term acute hospitals. Respondents were nearly evenly split among organizations with less than or more than 500 beds. Dr. Roga reviews 10 key results from the survey.
- The market for telehealth continues to rapidly grow. By the end of 2018, 64 percent of health systems, acute care facilities, critical access hospitals, pediatric providers and other organizations were offering consumer telehealth services. Worth noting, too, is the 24 percent of respondents who indicated plans to offer consumer telehealth by 2020.
- Hospitals are leveraging telehealth with goals increasingly aligned around revenue and care efficiency. Nearly 70 percent of health systems have aligned their telehealth programs with the goal to improve access. Other common organizational goals include reducing emergency room usage (34 percent), managing at-risk populations (28 percent) and strengthening post-discharge care (22 percent).
- More systems are facilitating 10,000-plus consults per year. Fourteen percent of health systems executed more than 10,000 telehealth consults in 2018 — more than two times what was recorded in 2016. Of the organizations with 10,000-plus consults, 43 percent were for acute care, 21 percent were for chronic conditions and 19 percent were for home care.
- Systems are moving their telehealth offerings past acute care to chronic care, remote patient monitoring and pediatrics. Of the 64 percent of systems expanding their telehealth programs by 2020, most will offer chronic care management (57 percent), remote patient monitoring (49 percent), post-op care (33 percent) and pediatrics (30 percent). "The pediatric market is now opening," Dr. Roga said. "Pediatrics will be the new market, that’s my prediction for 2020."
- Health systems are making substantial investments in providers, support and marketing. More than half of the organizations surveyed staff telehealth programs with their own providers, while 34 percent rely on a combination of their own providers and a vendor network. Following suit, 66 percent of organizations provide support capabilities internally, while 31 percent turn to an outside vendor for support services. The overwhelming majority (84 percent) of health systems invest $251,000 to $499,000 annually to market their telehealth program, while 5 percent invest upwards of $500,000.
- Fewer organizations are experiencing EMR integration as a barrier to telehealth. EHR-Integrated telehealth solutions are becoming more prominent, which has contributed to a reduction in the number of health system executives that perceive EHR integration to be a barrier to telehealth. In 2018, just 14 percent of respondents described EHR integration as a barrier to adopting telehealth, compared to 21 percent in 2017.
- Commercial reimbursement trends are improving. In 2017, 48 percent of hospital and health system respondents received commercial reimbursement for telehealth consultants. This pool has expanded in one year, with 60 percent of hospitals receiving commercial payments for virtual visits in 2018.
- Experienced systems track toward growing revenue, ER avoidance and consumerization. Systems with telehealth programs in place are leveraging the technology and e-consult capabilities to manage of chronic conditions (69 percent), reduce ER and urgent care visits (34 percent), offer more convenient care (28 percent) and grow revenue (16 percent).
- Most important lesson learned: Ensure organizational leadership is supportive and goals are aligned. Implementing and expanding a telehealth program has left executive respondents with several lessons learned, but the most important — based on survey results — are to secure physician buy-in, engage leadership and ensure the project aligns with organization objectives.
- International growth opportunities are becoming prevalent. Telehealth services reach is expanding as providers gain experience. Thirteen percent of systems are considering international expansion of consumer telehealth programs and the top three international markets providers are most interested in expanding to are the United Kingdom, Canada and China. Teladoc Health serves people across 130 countries in more than 30 languages.
A deeper dive into Teladoc Health's survey findings
On June 5, Becker's is slated to host a webinar on health system perspectives of consumer telehealth. During the webinar, Dr. Roga will further detail the key trends identified in Teladoc Health's 2019 survey. In addition to a more detailed analysis of survey findings, attendees will learn more about future growth opportunities for virtual care delivery, and hear unique insights and lessons learned regarding telehealth adoption documented by other health systems.
Click here to learn more about the webinar.