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Paper looks at strategies for implementing telehealth programs

By Joseph Conn

Adapting EHR systems to telehealth projects requires deconstructing the traditional healthcare encounter and unfettering telehealth from traditional revenue expectations, said Dr. Lee Schwamm, medical director of telehealth at Massachusetts General Hospital, Boston, in the current issue of the policy journal Health Affairs.

Other steps healthcare organizations must take: understand patients' and providers' expectations, be open to discovery, be mindful of the importance of space (both physical and emotional environments in which virtual healthcare encounters occur), design care to improve value in healthcare, and, lastly, be bold and visionary, Schwamm wrote in “Telehealth: Seven Strategies to Successfully Implement Disruptive Technology and Transform Health Care.”

Telehealth is a disruptive technology, Schwamm advised, but it also can “complement traditional ambulatory and hospital-based practices.” Telehealth does so “by creating delivery systems that are more patient centered and that use technology to increase access and quality, decrease cost, and help providers manage an ever-increasing volume of information and relationships,” he wrote.

Schwamm, who also serves as vice chairman of the Department of Neurology at Mass General, cites Pew Research Center studies that indicate 80% of U.S. adults who use the Internet have searched online for healthcare topics. In addition, “25% to 35% have read commentaries about health or medical issues and 15% to 20% have found other people with similar health concerns.”

Meanwhile, online communities, such as PatientsLikeMe, have formed to fill individuals' needs to find and share information about specific conditions.

So, it's time to start developing telehealth programs, Schwamm argued, as “important organization learning experiments.”

“It's unrealistic to expect a rapid return on investment for many telehealth applications,” Schwamm wrote. In general, he said, ROI should be considered “a long-term matter. The more that telehealth activities are directed to populations associated with financial risk (such as 30-day readmission penalties or alternative quality contracts), the less traditional revenue will decrease.”

Even so, he said, most early telehealth programs “will be financed by providers.”

On the other hand, Schwamm warned, there could be a financial disincentive for delaying the launch of telehealth programs until payments are better aligned.

Online “second opinion” and other services by telehealth vendors not only could compete for patients, but they also “could lure providers employed by hospitals away with offers of more lucrative payments,” he said.

Follow Joseph Conn on Twitter: @MHJConn


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