While telehealth is typically regarded as a new, emerging method of healthcare delivery, its origins are actually quite old. In fact, telehealth dates back at least to 1879, when an article in the Lancet discussed the practicality of using telephone calls to reduce unnecessary office or home visits. Dating not so far back, though still far enough not to be considered recent, healthcare providers in Alaska developed a telephone-based delivery system that helped determine whether patients should make a long (and sometimes dangerous) trek from their remote areas to see a doctor.
Despite the relative lack of novelty contained in telehealth, changes in healthcare and technology have paved the way for new, expanded use of telehealth services. As the cost of communication technologies has dropped drastically, their use has spread rapidly. Not only do people own telephones, but they are wireless, compact enough to be held in the hand, and uniformly reliable. In addition, computers come in both mobile and stationary formats, and high-speed internet access is available across widely-varying states and communities.
Beyond technological advances, the healthcare industry has begun to recognize the need for innovative approaches to care delivery. Telehealth was typically unprofitable in fee-for-service models, but Accountable Care Organizations, Patient Centered Medical Homes, and other strategies that focus on health outcomes rather than the services delivered allow for more provider autonomy in the way care is delivered. By focusing less on reimbursement for individual services and more on improving the health of a population, telehealth becomes a key tool in managing patients’ health in a high-volume, low-cost way.
Telehealth strategies may be particular effective for patients with chronic disease. More than 100 million, approximately one-third of Americans have at least one chronic disease, and these patients account for 75% of the health care expenditure. These patients visit Emergency Departments and doctor’s offices and are admitted to hospitals more frequently than those without chronic conditions. Previously, standard care was episodic, consisting of office visits or admissions, with little follow-up and coordination between. In part due to the ACA provision that penalizes hospitals for readmissions and in part due to a conglomerate of other cultural and legislative factors, healthcare providers are now using care management strategies to keep patients healthy and out of the hospital. Care management models involve frequent patient contact and regular monitoring, for which telehealth is ideal. Successful programs have been associated with reductions in hospitalizations, readmissions, lengths of stay, and costs, while simultaneously producing improvements in health, higher patient satisfaction, and better adherence to discharge plans and medications.
There are, of course, some barriers to effective use of telehealth. Implementing a telehealth program involves regulations regarding licensure and practice, reimbursement and payers, provider and patient education, and reliable technology. Doing so in a cost effective way can be challenging, but is not impossible. For assistance in developing and operationalizing telehealth in your hospital, VIE Healthcare is an experienced and dedicated partner. For more information, call (732) 359-7646.