A telemedicine panel waded into some of the challenges holding hospitals back from telemedicine adoption and best practice insights for delivery at the Institute for Health Technology Transformation conference in Boston this week.
Among the panelists were Shawn Farrell, director of telehealth at Boston Children’s Hospital; Dr. Stephen Beck, Chief Medical Informatics Officer at Mercy Health; Dr. Peter Antall, medical director, Online Care Group; Dr. Lee Schwamm, executive vice chairman, of the Department of Neurology and director of the Stroke Service, Massachusetts General Hospital; and Jake Hughes, senior sales engineer, Citrix. The moderator was Lynne Dunbrack, Research Vice President at IDC Health Insights.
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One of the biggest challenges for hospitals in implementing telemedicine is figuring out where to start. The general consensus on the best approach is to introduce one or two services at a time.
Webside manner
Farrell coined this phrase to describe some of the things that physicians and nurses interested in practicing telemedicine need to be aware of beyond technology issues. Just as with in-person visits, they need to be conscious of how they come across to patients. They need to ensure that they keep ambiance noise minimal, make eye contact with patients and dress in a professional manner. Good lighting is also important.
Payment models for consults
Schwamm noted that e-consults between primary care physicians and specialists with the goal of reducing needless specialist visits represent a big area of growth. At the same time, there also needs to be consideration about a way to compensate specialists for their knowledge rather than on visit volume.
Weighing what patients want vs. what health systems can do
Schwamm noted that most patients would prefer interacting with physicians in their home if it were safe, comfortable and affordable. Beck underscored that point and said the fact that some states limit telemedicine to a clinic rather than a patient’s home was a frustrating obstacle. Beck also emphasized the need to focus on communication with patients and earning their trust. Standardization of teh way telemedicine is delivered also makes a difference.
Economic value
Unless the economic value of transactions flows through the hospitals in some way, hospitals are unlikely to embrace it. One way to add more value to telemedicine is by addressing healthcare access-related concerns, Schwamm noted.
State legislation
Massachusetts legislature is reviewing a proposed telemedicine bill H267 introduced earlier this year that would expand access to telemedicine by allowing certain clinicians to be credentialed and to allow for coverage of these services by all payers and the Medicaid program. It’s currently in committee.