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Healthcare technology is a concept that amalgamates Information Technology (IT) with healthcare services. Telehealth can be considered a subset of this IT service which uses technology to deliver clinical healthcare via secure video and audio connection. According to Wikipedia, the earliest encounter for telemedicine dates back to 1876 when Mr. Bell used telephone to call Mr. Watson after he had spilled acid on his trousers. There are similar incidents throughout history where a doctor diagnosed someone over phone and/or radio.

In a time when healthcare spending is at record $3.6 trillion or $11,172 per person and accounts for 17.7% of GDP (2018 data), health service industry is looking for alternatives to reduce cost. Telemedicine is viewed as a cost-effective alternative to a more traditional face to face way of providing medical care. Apart from cost, another drawback in the current infrastructure is that clinicians are spending more time completing paperwork rather than spending quality time with patients.  Center for Medicare and Medicaid Services (CMS) is making a conscious effort and proposing Patients Over Paperwork initiative.

American Well, a Telehealth company, conducted a survey of 800 physicians in 2019 to access the current market for Telehealth as a service. Their survey results show that willingness to adopt Telehealth by physicians is at an inflection point.  There is a desire driven by physicians to improve patient access to care, improve patient outcomes and attract and retain patients. Some of the key outcomes of the survey are listed below:

• 69% of physicians said they are willing to adopt Telehealth services as compared to 57% in 2015
• 77% Physicians in the age group of 35-44 were the highest to show willingness for a video visit. Followed by 25-34 age group at 74% and 45-54 age group at 70%
• 93% of the physicians who have used Telehealth said it improves patient’s access to care, and 77% said it contributes to a more efficient use of time
• 71% of the physicians who use Telehealth today said they believe Telehealth will reduce health care spending and enable high quality communication with patients

According to KPMG survey conducted in 2017 by HIMSS Analytics, 31% of healthcare organizations use video-based telemedicine services and 34% offer remote patient monitoring. The figures prove that the business case for implementing virtual care programs is getting stronger as healthcare moves towards value-based care. The same survey indicated that another 44% of the organizations are eyeing for video-based telemedicine and 48% are planning for remote patient monitoring.

Various surveys and results have proven that hospitals and clinicians are suffering from lost patients and leaking revenues. Currently, the system suffers from 15-20% new patient loss rate because of elongated appointment lag time. KPMG survey indicated that there are 12-15% same day appointment cancellations or no shows because patients follow provider’s schedules making members skip appointments. Across all service lines, there is a strong co-relation between lag time and new patient loss rate. Further, the system has a lot of scheduling challenges. It takes almost 15 mins to reach a scheduler and nearly 33% of the patients abandon the call while waiting to connect. These challenges provide a great technological opportunity which patients are ready to adapt. Over 71% of the patients have shown positive outlook towards using online apps to schedule appointments.

What we can conclude based on various survey results and data presented above is that there is a gap in the market. This untapped market has also led to the debate whether Telehealth is a disruptive technology or not. As an avid follower of Late Dr. Christensen, I am of the opinion that this is a technology that can disrupt the market. Christensen’s disruption theory is not about how to design a solution differently but about how to compete differently. Research of Dr. Christensen points out that it is not innovative technology that disrupts a market, because in most cases both disruptor and the disrupted had similar technology and similar amount of technology. However, the disruptor was able to react to a market that was unaddressed, where behaviors and wants of the customers were changing. Thus, running away with the market share. Telehealth is in a similar phase, where it is trying to address patients’ urgent, unmet need for quality care along with access to the system. The technology advancement should support Telehealth to reduce healthcare costs. We need to create solutions that are profitable, scalable and sustainable.

We have seen how electronic health record (E.H.R.) adoption became stagnant. With 20% adoption rate in 2002 to 68-70% at the end of 2015. CMS has taken steps in the right direction with Patients Over Paperwork initiative. We hope CMS creates policies that enable ease in adoption of Telehealth.

Disclaimer: The facts and data presented above are taken from legitimate sources. Links to all sources are mentioned below and hyperlinked in the article for reference. The views stated are personal and based on interpretation of various data sources and readings.

References:

1. Removing unnecessary paperwork requirements through the PFS proposal would save individual clinicians an estimated 51 hours per year if 40 percent of their patients are in Medicare. Changes in the QPP proposal would collectively save clinicians an estimated 29,305 hours and approximately $2.6 million in reduced administrative costs in CY 2019.”
2. AmericanWell survey report: Telehealth Index 2019 Physician Survey
3. CVS health teledoc service: https://cvshealth.com/newsroom/press-releases/cvs-healths-minuteclinic-introduces-new-virtual-care-offering
4. The Innovator’s Dilemma: When New Technologies Cause Great Firms to Fail: https://www.amazon.com/The-Innovators-Dilemma-Technologies-Cause/dp/0875845851