There is no better time for the health IT community to come together under one umbrella to raise national awareness of the benefits information technology can bring to the US health system. National Health IT (NHIT) Week is a nationwide awareness week focused on the value of health IT. Each year, NHIT Week Partners educate industry and policy stakeholders on the value of health IT for the US healthcare system. Every Tuesday leading up to NHIT Week, our valued partners will share their voice and experience on how they demonstrate the value of health IT.
Over the last decade, technology has reshaped our approach to all kinds of daily interactions, and virtual healthcare delivery has unveiled the valuable potential of technology.
Telemedicine programs that allow patients to see a doctor via video videoconferencing have increased in recent years. However, the vast majority of patients still sacrifice hours of their day, traveling to a hospital or doctor’s office, filling out a plethora of forms by hand, and enduring long wait times, just to see a physician for what might be a quick follow-up exam or to refill a prescription.
Adopting Telemedicine in Our Healthcare System
So, what’s holding us back?
It is no longer the technology itself – there is nothing inherently challenging about using your phone or laptop to Skype with your doctor just as you would Facetime with family and friends.
There’s also no shortage of telehealth services. Some 63% percent of healthcare providers use telehealth in some way, for everything from follow-up visits to psychiatric consultations, according to a 2016 survey by Avizia. Yet the concept of consulting a doctor via videoconference still hasn’t become commonplace.
According to a 2016 Wall Street Journal article, the number of telemedicine visits grew by an estimated 20% from 2015 to 2016, but still only constituted a small fraction of the some 1 billion physician office and ambulatory care visits that happen every year in the United States.
The Human Factor
Having worked in health IT for the past two decades, I’ve come to realize that having access to the right hardware and software is important, but it’s the human factor – taking into account the needs of doctors and patients – that determines whether or not a program will work.
For digital health and telemedicine to succeed, we don’t necessarily need better technology; we need better processes, innovative applications and engaged participants.
Historically, health IT professionals haven’t done the best job of working with physicians and patients to develop telemedicine programs that are both accessible and effective. Electronic health records (EHRs) are a prime example of where we have gone wrong in the past.
While HIPAA regulations impose some necessary constraints on our ability to share medical information, too often, patients can’t easily access their EHR, and physicians have had to collect data from several different digital health records to receive a complete picture of their patients’ health.
Aligning Technology and Healthcare Delivery
Today, we have an opportunity to better align technology and healthcare delivery.
The primary obstacle is actually quite simple: caregivers have delivered medicine at the bedside for hundreds of years. Thus, as professionals and patients, we base our vision of healthcare around this model. We have begun to see some adjustments in terms of actual clinical practice – increasingly, physicians are developing and performing minimally invasive procedures that allow patients to avoid hospitals stays, and urgent care clinics give patients primary care options in convenient locations.
However, with telemedicine, we can give patients access to skilled physicians directly from their phone, thus negating the need to travel to a specialist or clinic.
In the past, it has been difficult for physicians to receive reimbursement from insurers for telehealth services, but that is starting to change, with many private insurers seeing the value in keeping patients out of the hospital, especially for routine appointments. As that trend continues, it’s important that we work closely with physicians, both in developing telemedicine platforms and instituting simple interventions during patient visits that will incorporate telemedicine as part of the standard of care.
You go to the doctor’s office after feeling sick. She performs an exam, diagnoses you, and gives you a prescription for a medication and instructions for how to take it. When she mentions she’d like to see you for a follow-up visit, you wonder when you’re going to take time out of your busy schedule to make it back in.
Then, you hear her say, “Actually, I’d prefer to do the visit via a videoconference, if that’s ok with you.”
It’s a relatively simple step, but it sets an expectation that telemedicine is the new norm.
As patients grow accustomed to this standard of care, insurance companies will more likely offer reimbursement for these types of services. Even Medicaid and Medicare, which have been historically reluctant to reimburse telehealth services, recognize the value of these services for patients in rural areas without easy access to doctors. But, why shouldn’t all patients have easier access to high-quality care?
With the right interventions in place, most outpatient visits could occur remotely within the next few years. Our goal at New York-Presbyterian is to achieve 20% in the next 18 months. That means more patients could expect easier access to high-quality care with just a few swipes on their smart phone. As healthcare professionals, to do right by our patients, we should welcome that expectation.