- For physicians using telehealth tools to connect with patients, that famed “aha” moment no longer comes when the technology is turned on. The real breakthroughs happen when a doctor begins an online conversation.
“Now, out of the gate, you’re giving providers a virtual care room,” says Noah Benedict, chief operating officer of the Rhode Island Primary Care Physicians Corporation. “The care itself isn’t innovative – that ability to communicate and collaborate is.”
The RIPCPC, which represents some 150 primary care and 200 specialty care physicians in the Ocean State, recently opened up that virtual care room to its members with the adoption of Seniorlink’s Vela platform. The telehealth technology gives providers a link to medical records, HIPAA-secure messaging tools, calendar and task-sharing options and asynchronous audio and video sharing.
More importantly, Benedict says, the platform pulls in not just doctor and patient, but all the members of the care team, including pharmacies, long-term supports and services, nurse care managers, patient advocates and family members and friends involved in the patient’s care.
“If you’re not including whoever’s responsible for different aspects of care, you’re really missing out on an opportunity to help the high-risk care member,” he says. “It makes sense to have everyone on the care team involved in that conversation.”
For example, a patient on multiple medications might need to be reminded when to take his or her medications, along with proper doses. Those duties are often filled by relatives, friends or home health nurses who don’t typically have a chance to talk to the doctor and instead rely on paper instructions or handmade charts.
In those environments, a doctor making changes in the care plan might not convey that information to everyone in the care team, or the doctor might not hear how those medications are affecting the patient’s mood, diet or activity.
“In the past these conversations were very informal,” says Benedict. “We were really beholden to the patient to make all the introductions, and a lot of things were missed. Now we can enroll the patient [in the online platform], visit with them virtually and ask that all the caregivers be included.”
Benedict says RIPCPC looked at several telehealth solutions before settling on Seniorlink, which was the only one to include caregivers on the platform.
That gap between technology and target population was spotted in at least two studies conducted last year.
One, conducted by HITLAB, found that 70 percent of caregivers surveyed are interested in using mobile health and telehealth tools to help care for a loved one at home, and 60 percent would use whatever’s available on the market – but only 7 percent are actually doing that. The second, by Parks Associates, found only 11 percent of caregivers use mHealth tools that feature medication lists and reminders, though 27 percent of caregivers are interested in those tools, as are more than 40 percent of people who expect to be caregivers someday.
According to that study, more than 30 percent of caregivers are also interested in mHealth tools that alert them to emergencies, provide digital storage for important medical information, offer alerts about out-of-range vital signs and provide a contact list with click-to-call function.
"More than 115 million Americans will require caregiving assistance by 2020, and their caregivers will include both medical professionals and family members," Harry Wang, senior research director for the Dallas-based market research and consulting company, said in remarks accompanying the June 2016 study. "Caregivers are interested in new technologies like medication management tools, but only 11 percent are presently using apps with this ability. There is great potential for future growth in this area, along with other caregiver support solutions such as remote patient monitoring and patient communication and engagement tools."
"The demand for caregiving applications is currently unmet and will grow in the future among both consumers and the medical industry," Wang added.
Benedict agrees, saying providers need to use telehealth tools that connect with patients and care providers on their terms and turf.
“In care management, engagement is the last bastion,” he says.
To test the platform, RIPCPC is enrolling roughly 500 patients with complex chronic care issues in a six-month pilot. The organization will ask family members and other caregivers to opt in to the program, and it will measure outcomes that include patient satisfaction, communications between patients and providers, medication reconciliation, organization of and access to advance directives and hospitalizations.
Benedict says the platform might also help the care team gather important information that a patient might not recognize or be able to provide, such as changes to the physical or cultural environment that might subtly affect one’s health.
“Through this portal, you’re making a meaningful connection to the patient, the caregiver and their environment,” he says, adding that his organizations care teams “are getting information that you just never would have received before.”