Mercy, which employs 2,100 physicians in clinics scattered across four states, launched its first telehealth program, a virtual intensive-care unit, roughly a decade ago.
The new building is expected to open sometime next year and be home to 300 physicians, nurses, researchers and support staff, facilitating an expected 3 million telehealth visits over the subsequent five years.
“There are not enough physicians and the costs too high,” said Dr. Tom Hale, executive medical director of telehealth services, in explaining the need for telehealth services.
One of major barriers to widespread adoption of telehealth in the U.S. has been a misalignment of incentives linked to fee-for-service payment models. Payment reforms provide compensation to cover not only the costs of running telehealth programs, but also to offset revenue losses when the programs keep people out of the hospital.
Three U.S. Agriculture Department grants totaling nearly $1.4 million dating back to 2011, have helped nurture Mercy's rural telehealth monitoring program and bring connectivity to rural emergency rooms, clinics and even schools.
But when the healthcare system started with an early telehealth program for intensive care, they started because “it was the right thing to do for patients in rural areas,” Hale said.
Mercy has about 300,000 patients in its system on some form of health insurance coverage that incorporates revenue-sharing models for quality improvement. They include a combination of Medicare Advantage and private plans from UnitedHealthcare, Cigna Corp. and Blues plans.
When people look back on funding for telehealth, the tipping point will be recalled as occurring sometime in 2012 or 2013, Hale said,
“It takes five to seven years to put the infrastructure together,” Hale said. “Not only do you need to start now, you'll learn early, this is about scale. Two thousand beds is what make sense for eICU.” And some of those beds need to come from outside your organization. In Mercy's ongoing telesepsis monitoring service, “We have one nurse that can monitor three or four hospitals at a time,” Hale said.
“You can't take the old thought processes, that we'll never collaborate with anyone,” and bring them forward. “This is all about collaboration,” he said.
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