Providers: Embrace Virtual, Ubiquitous Healthcare or Risk Extinction

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In large part, state and federal regulators are rolling out the red carpet for telemedicine. Are you ready? Here are ten crucial steps to take in your virtual care transformation.

There is little debate that virtual health is the future of healthcare. In fact, as has been written in this publication, the terms “virtual health, telehealth, and telemedicine” will be obsolete in the near future. Virtual health will be ubiquitous, a routine element of everyday healthcare. Health care systems and clinicians must embrace this shift in care delivery or risk being left behind.

Inconsistent and fragmented reimbursement and regulations have generated robust debate regarding the timing of when healthcare will make the ultimate virtual shift. However, healthcare providers must devote resources today to begin the foundational implementations of virtual health in order to keep pace with consumer demand and competition. A “wait and see attitude” could be catastrophic in today’s rapidly changing healthcare landscape.

Online physician visits are happening more and more frequently and investment in the telemedicine market is expected to grow to $13 billion in 2020. According to a recent survey, between 53 and 67 percent of adults are willing to use video to manage chronic conditions and as of 2015, there were 100,000 mobile healthcare applications. According to an estimate, more than seven million patients worldwide utilize remote monitoring and connected medical devices.

State government policy changes that make it easier for providers to offer and for patients to access telemedicine and virtual health care are gaining steam. There are several recent trends that show coverage expansion and standard-enhancing care delivery are on the rise:

1. Parity legislation requiring equal reimbursement for telehealth is becoming the norm
2. Almost half of states have signed onto the Interstate Medical Licensure Compact and in July 2017, North Carolina became the 26th state to join the enhanced Nurse Licensure Compact
3. Rules for a patient’s location (the “originating site”) during telehealth encounters are softening
4. New telehealth modalities beyond live video are being added
5. States are expanding the types of providers that can practice and be reimbursed for telehealth services

This is just the beginning. In the next decade, we expect to see the expansion of remote monitoring through wearables and implantable tech, plus an even more powerful smartphone experience. Phones and wearable technology will contain built-in sensors to act as glucose meters, stethoscopes, pulse oximeters, transdermal blood chemistry monitors, and other biometric monitors. Flash forward to a day when patients receive a message on a smartwatch or smartphone that alerts them to contact a clinician because of high blood pressure, irregular heart rhythm or abnormal blood chemistry/cell count.

These virtual health trends fuel the fire for providers to forge ahead, though do so carefully and methodically. Dr. Randy Moore, president of Mercy Virtual, summed it up succinctly when he said this regarding the transition. “You have to figure out how to go from here to there without imploding or going bankrupt in between.” Providers must assess, strategize and implement with forethought. Pushing forward too fast or in the wrong direction could be as detrimental as doing nothing at all.

No one can predict the future, and questions abound. What are the next steps toward realizing a future with ubiquitous healthcare? What are the patient needs to consider? Are patients ready to manage their own wellness? What can healthcare businesses do to be ready for this evolution?

10 crucial steps for providers to begin the virtual health transformation:

1- Remember the patients. Healthcare delivery today is physician-centric in design and, to no surprise, many virtual health programs are geared in the same fashion. While virtual health leaders continue to include the physician’s perspective in their efforts, they cannot ignore the patient’s point of view. It seems like a simple concept, but often no one asks the patient (or family) what would benefit them most. With increased competition from “payers as providers,”, internet-based telemedicine service companies, and the ever-present provider across town, understanding the patient’s “wants” is critical to success.

2- Don’t leave it all up to the techies. Integrate ubiquitous health strategically from a clinical standpoint, with IT as support, not vice versa. Virtual health is a fundamental change to how care is delivered, and how patient-to-clinician and/or clinician-to-clinician communication takes place. It requires detail, insight, oversight, and coordination from experienced clinicians. From the get go, clinicians must have input into the technology requirements to effectively deliver care. Streamlined methods that allow clinicians to provide timely suggestions and feedback must also be implemented.

3- Understand today before moving on to tomorrow. Most providers use virtual health in some capacity, but it is siloed. A full assessment and review of current capabilities, to include pros and cons of such, should be completed before planning for the future. In many cases, existing EMR’s and technology can be leveraged for future expansion. Also, in larger providers, it is not uncommon for there to be multiple duplicative technologies serving the same purpose. Cost savings can be achieved by consolidation and renegotiation with vendors.

4- Macro before micro regarding technology. Multispecialty providers should evaluate potential technology partners across all specialties initially. Virtual health vendors are becoming more sophisticated and offer solutions that can cover the enterprise. If a system initially focuses solely on a single service line they may pick a vendor that does not meet other service lines. There is always a place for best in breed to meet an individual service line’s needs, but these should only be selected after an enterprise-wide scan is completed.

5- Understand the regulatory and reimbursement trends, challenges and opportunities, driving change toward achieving ubiquitous healthcare. Evolving national, state and local health regulations and laws, and clinician licensure, are challenges that must be meticulously planned and managed. New or proposed reimbursement models must be evaluated for the role of virtual health.

6- Examine target patient population changes. More than 20 percent of the U.S. population will be over 65 by 2040, 44 percent have functional limitations, 60 percent manage two or more diseases. Alzheimer’s affects more than 5.4 million seniors, so technology that provides automatic reminders or instant care will become more important. Socioeconomic status and cultural components, including populations who speak English as a second language, are also key components to weigh.

7- Collect and analyze data. Fast expanding capabilities to access, integrate, and analyze traditional and non-traditional data will improve evidenced-based clinical practice and self-care, enhance customer insights, and improve collaboration and communication. With this advancement, there must be a collaboration between clinicians and the data analysts to understand what really matters and to filter out data “noise.” Providers should also closely evaluate what data is requested from patients. Asking the same questions repeatedly or taking a shotgun approach to gathering patient data is a dissatisfier. Clinical relevance and value should be the driving principal regarding data collection and analytics.

8- Influence mindsets regarding virtual health. A shift is happening from viewing individuals simply as patients to empowering consumers who utilize self-care approaches and value-based shopping while comparing healthcare options. A well-planned marketing and communication plan must be part of any virtual health implementation. And, providers must not forget to market internally. Many a virtual health programs fail due to lack of clinician buy-in. A well-respected clinical champion should be assigned to represent the overall and service-specific virtual health programs. This champion must possess impeccable communication skills and be highly regarded by the medical staff.

9- Plan for a change in facilities. Telehealth’s effects on post-acute and chronic care (e.g., the number of open hospital beds, the number of hospitals, and clinics needed, etc.) will change as more care occurs at home via remote monitoring and digital interaction. As care is pushed further toward the patient’s home, the need for the traditional inpatient hospital room and medical office building will shrink. Satellite virtual brick and mortar clinics staffed by lower cost clinicians and supported by virtual specialists will be the norm. As post-acute treatment is moved to the home, distribution centers for efficient delivery and tracking of medical equipment will be needed.

10- Dream for the future. What’s beyond 10 years? Already there is talk of drone drug and supply delivery, autonomous vehicles equipped with imaging equipment, home kits for common lab tests, robot caregivers, nanobots that scan inside the body for disease or break up clots, and human organs grown in labs. These possibilities may or may not come true based on what people desire, what they can manage, and their tolerance for non-personal interaction. Futures studies can create strategic foresight to help with the exploration of possible futures and their implications. This helps identify unique insights that enable organizations to become more resilient, anticipate change, and make better strategic decisions.

Plan for ubiquitous health today by choosing the right leadership and stakeholders, understanding the current state, all with a lens looking toward the future. Adequate preparation will lead to a place where consumers will enjoy the highest convenience, the lowest cost, and the best outcome, and organizations will benefit from improved productivity, lower costs, and increased employee retention. Ideally, once virtual health is ubiquitous, the world will be a healthier place to live.



Principal, North Highland

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