Why is physician telehealth turnover so low? Q&A with Teladoc Provider Division President, Dr. Alan Roga

Direct-to-consumer telehealth programs are cropping up at hospital systems nationwide.

 This content is sponsored by Teladoc. 

Becker's Hospital Review caught up with Alan Roga, MD, president of the provider division at Teladoc, about the state of direct-to-consumer telehealth and its affect on physician satisfaction rates.

Dr. Roga trained as an emergency medicine physician and is a fellow of the American College of Emergency Physicians as well as a diplomat of the American Board of Emergency Medicine. He founded StatDoctors, a national telehealth company, in 2009 and helmed the company as CEO through its acquisition by Teladoc in June 2015.

Editorial note: Responses have been lightly edited for style and length.

Question: How important is it for hospitals to begin thinking about consumer telehealth programs?

Dr. Alan Roga: Consumer telehealth programs have two main value drivers. For one, they're a low-cost way to finance greater access to care, thereby also helping organizations manage the financial risk of a population. The other main value driver is market share and growth strategies, both of which have to do with reaching consumers external to the hospital's system. 

Consumers are different than patients. A consumer is someone who is thinking about where they want to get healthcare, whereas a patient is already receiving some type of care in the system. Consumers go online and research where to go before they get healthcare services. They're looking for care that is convenient and on their terms. Consumerism is changing the way healthcare is being delivered, and patients now value convenience as much as quality and cost. For many consumers, what they're interested in is being able to see a physician from their home. About 60 percent of consumers said they are willing or interested in seeing a physician online.

Increasingly, hospitals are recognizing — and seizing — the market opportunity here. About 76 percent of hospitals have or are planning to implement a consumer telehealth program in the next 24 months, according to a recent survey by Teladoc and Becker's Hospital Review. Of organizations with programs in place, 69 percent are planning to expand their consumer telehealth services.

Those statistics mean hospitals are doing one of two things; they're either implementing direct-to-consumer telehealth programs to get ahead of the crowd and compete for new patients, or they're responding to competitors in their market who have already implemented DTC programs and are trying to stay relevant.

Looking forward, hospitals need to strategically think about how they're going to meet consumers' needs better than their competitors in their market. If they don't embrace the consumer, the consumer will go find someone else for healthcare services and that will hurt the system's standing in the market.

Q: What is the relationship between consumer telehealth and physician satisfaction?

AR: It's extremely positive. About 57 percent of physicians said they're interested in participating in consumer telehealth. Ninety-six percent of Teladoc physicians reported high levels of satisfaction. I think you have very satisfied physicians for several reasons. 

For one, consumers who use telehealth services report higher satisfaction rates than patients who visit physicians' offices. Physicians really like that their patients are highly satisfied with their care. Moreover, as opposed to an average in-office no-show rate of 6%, consumer telehealth has a no-show rate of less than 1 percent. Physicians are frustrated on a daily basis by patients who don't show up for appointments, which hurts revenue and wastes time. Online telehealth appointments are not only satisfying for patients, but they also make physicians' daily practice more efficient. 

When it comes down to it, physicians are just as much "consumers" of care delivery as patients; they have preferences for how, when and where they'd like to treat patients. Many physicians are frustrated with their current practice. Telehealth gives them a way to meet consumers on their terms while practicing on the cutting edge.

Stakeholders were concerned with patient safety at the very beginning of telehealth, but that's no longer the case. As an example, Teladoc has completed nearly 3 million patient encounters with no malpractice suits. Our hospital partners are also expanding capabilities well past acute care. They are finding with a little creativity, telehealth is delivering profound results.

Q: What are the key differences in implementing direct-to-consumer telehealth programs versus other types of telemedicine programs at hospitals?

AR: There are several key differences. However, the main difference is how the use cases impact the access being provided. Telehealth inside a hospital system is primarily focused on a patient  in a hospital room or clinic and connecting to a physician located somewhere else in the system. This typically requires hardware and purchasing physical materials. It also can significantly control the encounter through predetermined hardware and software requirements, scheduled times and support staff needs.

On the other hand, consumer telehealth involves connecting  consumers and physicians  on their terms. The consumer can be on his mobile phone or tablet device either in his house or on the go. The physician can be in his or her office or at home using either her laptop or desktop computer. It's a much more a candid, unscheduled encounter that involves software based on the consumers preference rather than hardware. So when a hospital system is deciding how to implement a DTC program, they need to think about software that supports a multimodality experience and works on all types of platforms. The consumer might be in an area with a low bandwidth, so the hospital system needs to be sure the software can support video at a low bandwidth.  

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