- Telehealth can be a powerful tool in reducing costs and improving outcomes. For traditional health systems, it also might be the perfect antidote to that new urgent care clinic down the street.
With the advent of so-called direct-to-consumer healthcare, hospitals are now finding competition in retail clinics and urgent care centers. No longer can the friendly, established neighborhood health system sit back and expect everyone to walk in through the front door when they need help; independent clinics now offer quick and immediate care, at a lower cost, to consumers looking for convenience.
With a telehealth platform, however, a health system can match that convenience and cost and offer one thing the retail clinic can’t: access to one’s own primary care doctor.
“Healthcare is still personal – that is the key,” Keith Algozzine, CEO of New York’s Upstate Concierge Medicine, told an audience at this week’s American Telemedicine Association Fall Forum in New Orleans. Telehealth, he added, is an opportunity for traditional health systems with an engaged patient population “to go out there and keep these patients engaged.”
Algozzine, whose company works with healthcare providers to launch telehealth concierge services, and Stephen Jones, vice president of the Carolinas Medical Group, which launched a branded telehealth platform with American Well in late 2014, both see telemedicine as a necessary tool that healthcare providers must use to compete in a value-based economy.
But until that system takes hold and while fee-for-service is still pretty much the law of the land, developing a virtual care platform to compete with retail clinics can be challenging.
Jones said Carolinas Health’s 200+ physician practices in and around Charlotte, N.C., were hesitant to adopt a consumer-facing telehealth service that offered near-instant access around the clock for any healthcare need, especially without a solid reimbursement plan. It was a classic example of an established system reluctant to accept change.
“That opened the door for retail clinics to come in and take hold,” he said.
“Consumers aren’t thinking about healthcare as we think about it,” Jones added. “It is an obstacle in their daily lives that keeps them from doing what they want to do,” so they want a quick, convenient solution to that obstacle. If they can run into a clinic down the street or in the local supermarket or mall, get a nagging cough checked out and get a prescription, all at a fraction of the cost of a visit to the hospital or doctor, they’ll jump at that.
Jones said Carolinas Healthcare responded by creating a telehealth platform, focusing on the concept of “local care by local providers.” But they didn’t know how to market the service or let consumers know it was available. They contracted with American Well for a hosted platform.
They expected 20,000 to 30,000 visits in the first couple of years, but only got 4,000.
“It’s been difficult,” he said.
Alogozzine said traditional healthcare providers also tend to overthink telehealth platforms, making it more complex than it needs to be. Administrators need to identify the demand and match that with the resources available and affordable – usually mid-level clinicians.
“Do you really want to pull your highest trained (doctors) to treat a 22-year-old with pink eye?”
The key, said Algozzine, is to “find ways to just lower the barriers to entry,” so that consumers will try out the service and appreciate it enough to want to come back when the need arises.
While emphasizing the connection to local doctors, Smith said it’s also important to point out to consumers that a telehealth platform run by the local health system offers a more comprehensive care management plan than the local retail clinic. That includes an integrated medical record and management of follow-up and specialist visits, even prescription refills.
“We’ve seen consumers choose groups that can help manage that care coordination,” he said.
Nate Lacktman, a telemedicine attorney with Foley & Lardner and the session’s moderator, suggested that healthcare providers look at what they do best. Academic medical centers and specialty practices, for instance, should focus their platforms on online specialty consults.
It's also important, he said, to map out a business plan that defines goals over a few years, not just the immediate future.
Smith sees a rosy future for Carolinas Healthcare’s telehealth platform – eventually.
“Telehealth eventually becomes just an immense problem-solver for you,” he said. “But until we redesign physician compensation models to be value-based … it will continue to be tough.”