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Telehealth Trends: Telemental Health, Direct-to-Consumer Care

The Advisory Board Company's update of its 2015 telehealth survey finds that telemental health, telepsychiatry and direct-to-consumer care models are trending, while doctors aren't that interested in teleconsults.

Source: ThinkStock

By Eric Wicklund

- Healthcare providers are adopting telehealth for telemental health and psychiatry services, and they’re far more interested in direct-to-consumer care than in using the platform to talk to each other.

Those conclusions come from the Advisory Board Company, a Washington, D.C.-based best practices firm that recently updated its landmark 669-question 2015 telehealth survey.

According to company analyst Lauren Lawton, the company saw an 18 percent increase in queries related to telehealth in 2016, but found that the increase doesn’t exactly mean that the telehealth and telemedicine industry has reached what so many believe to be its tipping point.

“[S]ome of that growth can be attributed to payers and other health care players,” she wrote in a recent blog, but “[w]hat these questions had in common is that the majority came from individuals purely interested in learning more about telehealth. This could indicate that many are still in the beginning stages of program development.”

In fact, Lawton said planners - instead of “payers and other players,” such as clinicians – made up 77 percent of the inquiries received by the company in 2016. This indicates that healthcare providers who haven’t yet adopted a telehealth or telemedicine strategy are still in the planning stages, and looking at a system-wide implementation rather than at specific service lines.

That said, Lawton said clinical leaders who have contacted the company are interested in psychiatry and behavioral health – 22 percent of the questions were on that topic, “a significant spike in interest compared with the previous year.” Other hot topics, she said, were telestroke (14 percent) and eICU (12 percent).

Telebehavioral and telemental health and telepsychiatry services have be trending upwards for some time, propelled by consumer-facing platforms like those provided by American Well, Teladoc and MDLive and the Veterans Health Administration, which created a National Telemental Health Center in in 2010 and has been expanding online and mHealth services for veterans since then.

“In particular for this field, telemedicine has a lot of advantages,” says Rene Quashie, a longtime telemedicine expert and attorney for Cozen O’Connor’s healthcare practice. “The ability to expand the communication platform [from the office to other locations, like the patient’s home] is becoming very popular.”

Aside from that service line, the interest in telestyroke and eICU services isn’t unexpected. Several large health systems, like Kaiser Permanente and the Cleveland Clinic, have reported that telestroke platforms can save lives and money, and Congress may soon take up the Furthering Access to Stroke Telemedicine (FAST) Act, which would, if passed, allow Medicare coverage of telestroke services no matter where the patient is located.

eICU services, meanwhile, have proven their value in places like St. Louis-based Mercy Virtual, which sits at the hub of a national hub-and-spoke telemedicine network; and Emory Healthcare in Atlanta, which recently ran its eICU service through a hospital in Australia. The platform was also the subject of a recent study conducted by UMass Memorial Medical Center.

Beyond those service lines, Lawton said clinicians are interested in telemedicine for new or relatively unproven uses. Some 30 percent of the questions fielded during the past year, she said, touched “on services not yet considered standard for telehealth”

“Oncology and genetic counseling emerged as prominent interest areas, particularly when compared with the very limited attention these specialties received throughout 2015 inquiries,” she said.

Finally, the Advisory Board Company has found that doctors aren’t all that interested in using telemedicine to talk to each other, but they are very interested in using the technology to connect with their patients. And they’re more interested in virtual visits than remote monitoring or store-and-forward platforms.

“Direct-to-patient modalities are likely a strong area of interest due to their potential for significant impact on care delivery and the continued difficulties surrounding implementation,” Lawton concluded. “While virtual visits may have the ability to shift significant volumes of care and expand access, uncertainty remains for many institutions regarding reimbursement levels, compliance standards and best practices for planning.”


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