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Telehealth Innovation Forum highlights new models in care delivery

Larry McClain

Larry McClain, Guest Editor

The ninth annual Telehealth Innovation Forum held in late July in Santa Barbara, California demonstrated how rapidly telehealth is transforming care delivery. The event, hosted by InTouch Health, showed that telehealth is extending well beyond acute care clinical services (telestroke, teleICU, etc.) and improved access to specialists for underserved rural communities.

Here are some of the main takeaways from the Forum:

Telehealth provides exceptional care across the continuum 

Enterprise-wide telehealth platforms now connect large hospitals, small community facilities, emergency departments, skilled nursing facilities (SNFs), rehab centers, EMS ambulances, urgent care/retail clinics, home health providers, and even inpatient/outpatient surgery centers. With the rapid maturation of telehealth technology, “the care continuum” isn’t just a buzzword. It’s a complete ecosystem that delivers better care coordination and lower costs.

Many of the largest and most prestigious U.S. health systems are leading the charge 

The Forum agenda included presentations from clinicians and telehealth program executives at The Cleveland Clinic, Stanford University Medical Center, HCA, Thomas Jefferson University Hospitals, Dignity Health and other influential health systems. Many of these telehealth programs have impressive scope and scale. In its last fiscal year, the Dignity Health Telemedicine Network conducted nearly 12,000 clinical consults in 11 different specialties to 39 partner facilities.

Telehealth is helping lower hospital readmission rates 

According to The Advisory Board, 2,665 hospitals are facing readmission penalties in fiscal year 2016, resulting in a combined loss of $420 million in Medicare payments. Pinnacle Health in Harrisburg, Pennsylvania is ahead of the curve,using the InTouch telehealth platform to reduce rehospitalizations by coordinating care with SNFs and extended care facilities in its service area.

Telehealth is helping lower the cost of care for “superutilizers” 

Telehealth technology makes it much easier for nurse navigators to quickly determine which patients need emergency care and which ones can be treated in a less expensive setting.

Telehealth is improving the accuracy of stroke diagnoses 

While rapid administration of clot-busting tPA helps many stroke patients, it’s ineffective and potentially harmful for those who need surgical endovascular treatment. The Stanford Stroke Center has developed software and PACS technology that helps remote neurologists rapidly assess whether a stroke patient is a suitable candidate for tPA or would respond better to surgical endovascular therapy.

Advances in 4G/LTE technology are enabling health systems to create mobile stroke units 

For example, The Cleveland Clinic now has an ambulance equipped with an 8-slice CT scanner and lab equipment onboard, with a four-person crew (including a critical care nurse). 

Telehealth is dramatically lowering the cost and timeliness of surgical proctoring 

It’s time-consuming and expensive to have proctors and experienced surgeons travel to hospitals to monitor or teach cutting-edge procedures. Thanks to the visual acuity of telehealth platforms, physicians can monitor these procedures remotely. For instance, Children’s Mercy Hospital in Kansas City, Mo. has launched a teleproctoring program that lets world-renowned surgeons proctor complex fetal surgeries from a remote location.

Telepsychiatry is lowering costs and improving outcomes for behavioral care patients 

InTouch Health CEO Dr. Yulun Wang, Ph.D., noted that the InTouch platform is helping reduce the average wait-time for a psychiatric ED visit from the national average of 6.5 hours to just 19 minutes.The Agency for Healthcare Research and Quality estimates that about 6.5 million people visit hospital EDs for psychiatric treatment each year, and one study found that hospitals lose an average of $2,264 for each in-person psychiatric consultation. With telehealth technology, hospitals can gain revenue of more than $2,200 per remote consultation.

Telehealth is being widely used in urban locations, not just rural communities

For many people, the words “telehealth” and “telemedicine” are synonymous with providing high-end health services to rural hospitals that lack them. But that’s just one example of how the technology is improving care delivery. In traffic-congested cities like Los Angeles and Houston, hospital transport can take hours. Telehealth lets more patients be seen in their local hospital or PCP office, providing faster consultations and better outcomes.

Telehealth gives burn patients rapid access to the nation’s top specialists 

There’s a limited number of accredited Burn Centers in the U.S., and telehealth can quickly connect a burn patient with a specialist at one of those facilities. The Joseph M. Still Burn Centersbased in Augusta, Ga. are in the forefront of teleburn technology, leveraging lessons learned at leading hospitals like Massachusetts General Hospital.

Doctors are learning how to be “virtualists” 

Providing expert care remotely involves a unique set of patient interaction skills. Thanks to the pioneering efforts of people like Dr. Herb Rogove, MD, at C3O Telemedicine in Ojai, Calif., thousands of physicians around the world are learning how to become a “virtualist” – the remote caregiver that the patient sees from the neck up on a telehealth device. 

Telehealth is truly going global 

Clinicians from King Chulalongkorn Hospital, one of Thailand’s top academic medical centersbased in Bangkok, shared how they’re using the InTouch platform to better serve patients across the country – and to consult with their medical peers throughout the world.

Another Forum highlight was the rousing keynote address from Dr. Reed Tuckson, MD, the new president of the American Telemedicine Association. Tuckson promised to be a bridge between telehealth advocates and the American Medical Association, CMS and both state and federal legislators.

There was a common theme among Forum presenters: telehealth adoption requires cultural change and elimination of barriers. Some physicians still perceive that telehealth gives specialists too much power to look over their shoulders. And some nurses feel that they’re already too busy to facilitate telehealth’s new care delivery processes. But the Forum showed that health systems of all sizes – and their partner organizations – are now embracing change. It appears that telehealth’s long-awaited tipping point has finally arrived.

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