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Providers Like Virtual Care, But Sustainability Issues Linger

KPMG finds that three-quarters of health systems surveyed have a telemedicine platform in place or are launching pilots, but less than half have reached sustainability, which is still the biggest barrier to adoption.

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- Roughly three-quarters of healthcare providers in a new survey say they’ve launched a telemedicine platform or are beginning pilot projects, but less than half say they’ve reached sustainability.

The survey of 147 health systems, conducted by HIMSS Analytics on behalf of the consulting firm KPMG, finds that about three-quarters either have a virtual care platform in place or are planning on launching one. Thirty-one percent are now using video-based services, and 34 percent are using remote patient monitoring tools. And about half of them are using clinician-to-clinician consults or continuous monitoring through a telestroke or teleICU service line.

“We are seeing a strategic shift in how providers are thinking about investment in digital health capabilities, including virtual health platforms, enhanced portals and web interaction, as well as scheduling and referral management tools to improve patient experience,” Michael Beaty, a principal at KPMG’s Healthcare and Life Sciences practice, said in a press release.

But sustainability is still the strongest barrier to adoption. About a quarter of the health systems surveyed said “maintaining a sustainable business and/or financial model” is their biggest challenge, followed by clinician acceptance (17 percent) and defining a virtual care strategy and regulatory compliance and risk/liability concerns, both at 12.2 percent.

The survey highlights the still-evident divide between health systems who have programs in place and those still focusing on pilots. In a recent interview with mHealthIntelligence.com, Jonathan Linkous, CEO of the American Telemedicine Association – which opens its Telehealth 2.0 conference and exhibition this weekend in Orlando - said the healthcare industry has moved beyond pilots and needs to tackle sustainability.

With the “acceleration of the industry, there’s a need for a more solutions-based environment,” he said.

When asked about the maturity of their virtual care initiatives, about 45 percent of the health systems in the KPMG survey said their program is sustainable; 4.5 percent said they have an advanced program supporting more than five service lines, 18 percent said they have centralized governance and 21.6 percent said the platform is still decentralized, with service line-specific technologies.

Meanwhile, 45 percent say “the time is right,” and they’re launching one or two pilot projects. Another 28.8 percent say they’re still in the early stages, with less than three full-time staff supporting two or more service lines.

At Xtelligent Media’s Value-Based Care Summit last November in Boston, executives from several health systems with telemedicine programs in place said it takes time to shepherd those programs to a point where they can stand on their own. Sustainability comes when both providers and patients adapt to the new platform.

“Telehealth is still in its infancy,” John Campbell, the Spaulding Rehabilitation Network’s chief information officer, said at the conference. Spaulding’s goal, he said, is to “create alternative pathways to care” that work better and more efficiently for both patient and provider.

Linkous says health systems have to move away from the idea that telemedicine is a project and focus on making it a pathway to better business.

The payment question is different than it used to be,” he said. With fee-for-service healthcare slowly being phased out, providers have to learn how to incorporate telemedicine into value-based care. That means understanding the shifting value proposition in healthcare, and dealing with expected changes to both Medicare and Medicaid.

Linkous also expects a lot of discussion at next week’s ATA conference on consumer-facing healthcare, whether it’s through direct-to-consumer telehealth or portals and mHealth apps.

“We’re changing the way healthcare is delivered,” he said. “Convenience has become a driver for healthcare, and that’s something many [providers] hadn’t thought about before.”

As the KPMG survey points out, health systems see the potential of telehealth, even as they seem to be taking their time getting there.

“The business case for implementing a virtual care program is improving as healthcare evolves toward value-based care incentives from limited fee-for-service reimbursements,” Richard Bakalar, KPMG’s managing director, said in the release accompanying the survey. “It’s more efficient for high cost and limited clinical staff as well as other onsite resources, while making it more convenient and timely for patients to receive their care.”

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