Low adoption of telemedicine may push patients away from traditional providers
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Perrigo sells generic drug business for $1.55 billion
      Proposed overhaul of Arkansas Medicaid expansion unveiled
      Tensions over vaccine equity pit rural against urban America
    • Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Tensions over vaccine equity pit rural against urban America
      States easing virus restrictions despite experts' warnings
      Average nursing home nursing staff turnover exceeds 100%, report finds
    • Dr. Marc Boom
      Q&A: Houston Methodist CEO praises staff efforts to keep vaccine efforts going during ice storm
      The Check Up: Dr. Marc Boom
      The Check Up: Dr. Marc Boom of Houston Methodist
      Charles-Shor_160x200 1_i.jpg
      Cleveland Clinic receives $15.5 million donation for new neurological institute
      Dr. Imran Andrabi
      Q&A: ThedaCare CEO says lessons from COVID-19 will inform new approaches to population health management
    • Highmark, HealthNow finalize affiliation, creating fourth-largest Blues plan
      Low 2020 utilization could affect insurer profits for the next two years, analysts say
      CMS: Group health plans must cover COVID-19 diagnostic testing
      High MLRs inspire insurers to focus on quality improvements
    • Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Proposed overhaul of Arkansas Medicaid expansion unveiled
      States easing virus restrictions despite experts' warnings
    • UPMC's patient volumes stabilize, boosting 2020 profits
      Genomics firms taking advantage of SPACs trend to go public faster
      COVID-19 could dent hospital revenue by at least $53 billion in 2021, AHA says
      deloitte GDP image chart graph going up
      Sponsored Content Provided By Deloitte
      Breaking the cost curve
    • Teladoc reports $383.3M in fourth-quarter revenue, up 145%
      man and woman looking at ipad wearing face masks stock image
      Sponsored Content Provided By Surescripts
      Improvements to benefits data can enhance ePrescribing and the patient experience
      Oscar Health's $1B IPO sets the stage for more health tech exits in 2021
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
    • Tensions over vaccine equity pit rural against urban America
      Utah cancels vaccine appointments after registration error
      Connecticut is doling out vaccines based strictly on age. It's simpler, but is it fair?
      Great-granddaughter of Tuskegee study victim gets vaccine
    • Alicia Wilson
      Q&A: Emerging leader Alicia Wilson on staying close to home
      Michael Jordan, Novant team up to address health equity
      Former Ascension CEO, the first to lead the health system, passes away
      Biden's pick to head CMS would be first Black woman to hold post
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
    • What's next for on-demand telehealth companies?
      A CalOptima PACE vaccination clinic.
      Will COVID-19 be the catalyst for creating a more sustainable healthcare system?
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
      Ascension’s St. Mary’s Hospital Surgery Center at Towne Centre and Allegheny Health Network’s Bethel Park surgery center
      Hospitals see opportunity, risk in ambulatory surgery centers
    • Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • What's next for on-demand telehealth companies?
      Rising prescription copays drop adherence, spike mortality, research shows
      Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      Highmark Health inks six-year cloud, tech deal with Google
    • Hospitals' Medicare billing practices suggest upcoding, OIG says
      California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
    • Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      Humana partners with in-home provider for 24/7 care
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
    • Bundled payments reduce surgery costs by 10.7%
      Coordinated payment policies could speed transition to value, experts say
      CMMI's geographic direct contracting model needs an overhaul, experts say
      Hospitals fight UnitedHealthcare policies over lab test, specialty drug payments
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Dr. Alan Kaplan
      The risks, rewards of taking organizations 'where they haven’t gone before'
      Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
    • Dr. Stephen Markovich
      Making sure we're aligned along the path to achieving inclusion
      Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
    • Mikelle Moore
      The promising future of rural healthcare, even amid the COVID-19 pandemic
      In-person visitation must be part of the national COVID-19 response
      We've lost so much to the pandemic, but we've also made gains that will endure
      Medical groups key to meeting president's vaccine pledge
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Minorities in Healthcare
      • - Luminaries
      • - Top 25 Minority Leaders
      • - Minorities to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • podium march webinar logo lockup
      Sponsored Content Provided By Podium
      Webinar: Critical Touchpoints for Every Patient’s Journey — How Technology Plays an Important Role
      scp health logo lockup march 2021
      Sponsored Content Provided By SCP Health
      Webinar: COVID’s call to action — Reset for success in 2021
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Healthcare Transformation Summit
    • Leadership Symposium
    • Virtual Briefings
      • - Hospital of the Future
      • - Mental Health
      • - Patient Safety & Quality
      • - Strategic Marketing
      • - Virtual Health
      • - Workplace of the Future
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Next Up Podcast: Educating patients on the COVID-19 vaccine with Tanya Andreadis
      Dr. Joseph Cacchione
      Next Up Podcast: Educating patients on the COVID-19 vaccine with Dr. Joseph Cacchione
      Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
    • Beyond the Byline: Insurers are betting on virtual-first plans as COVID-19 shifts care pathways
      Beyond the Byline: How residents' stories shape our coverage of the vaccination rollout in nursing homes
      Beyond the Byline: Regulators aim to boost value push with fraud and abuse law updates
      An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
    • Outreach during COVID-19
      Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Dr. Marc Boom
      The Check Up: Dr. Marc Boom of Houston Methodist
      The Check Up: Dr. Imran Andrabi
      The Check Up: Dr. Imran Andrabi of ThedaCare
      The Check Up: Tanya Blackmon
      The Check Up: Tanya Blackmon of Novant Health
      The Check Up: Dr. Patrick Hwu
      The Check Up: Dr. Patrick Hwu of the Moffitt Cancer Center
    • ivana naeymi-rad one on one intelligent medical objects
      Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Technology
March 23, 2019 01:00 AM

Low adoption of telemedicine may spur patient migration away from traditional providers

Steven Ross Johnson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print

    Telehealth visits like this one will become the norm for systems that embrace the model.

    Stanford Children’s Health started small when it began offering telehealth services a decade ago, primarily focusing on providing clinic-to-clinic virtual physician visits with limited capability to consult directly with patients in their homes. 

    But strong demand for such interactions from both patients and clinicians prompted the system to increase the size and scope of its telemedicine program about three years ago, helping the system to become more patient-centered.

    “What telehealth enables us to do is take the care to the patient when they need it, where they need it, and stop disrupting their lives as much,” said Dr. Natalie Pageler, chief medical information officer at Stanford Children’s.

    The number of virtual visits at Stanford Children’s has exploded over the past two years, rising from just 192 in 2017 to more than 1,100 in 2018, and more than 1,500 already in the first few months of 2019. The goal is to reach 2,500 by year-end.

    But many healthcare providers and administrators are not eager to upend their standard model for care delivery, which likely has been in place for decades. As a result, only a fraction of hospitals and health systems have adopted telemedicine, which in the coming years could cause them to lose patients to the burgeoning market of convenient-care options that include telehealth operators, free-standing emergency departments, urgent-care centers and retail health clinics.

    Pageler said the failure of hospitals to fully adopt telemedicine is creating a gap in care that she fears is being filled by organizations that may have lower standards. “I’m concerned that some of those providers may not have the same level of skill or knowledge that we provide here,” she said. 

    Healthcare has been slow to adopt telemedicine. In 2016, just 15% of physicians worked in practices that used telehealth, according to a 2018 American Medical Association survey published in Health Affairs. Still, in dollar terms, telehealth services have grown by 44% over the past five years, according to industry research firm IbisWorld, with a total market revenue of $2 billion in 2018.

    Lori Uscher-Pines, senior policy researcher at the RAND Corp., said adoption has also been slow among patients, where uptake is typically between 1% and 20% when a telehealth option is introduced. “We think that’s just a factor of getting people used to receiving healthcare this way,” she said. “There’s just an initial hesitation to change.”

    Uscher-Pines said direct-to-consumer telehealth has been part of a broader push in healthcare toward convenience that has created a change in how patients are accessing care for minor health conditions. Hospitals that have embraced telehealth have mostly supplemented their current care-delivery apparatus by using virtual visits to handle those lower-acuity patients.

    Fundamental change

    Carey Officer, operational vice president for Jacksonville, Fla.-based Nemours Children’s Health System’s Center for Health Delivery and Innovation and administrator of its telehealth program, said telehealth’s biggest potential impact will likely be the way it changes the nature of the primary-care clinic. 

    Officer said physicians will likely spend more time in front of a screen conducting video consultations than seeing patients in person. “I think there’ll be a different sense of who’s walking in the door on a daily basis,” Officer said. “There will always be a need and a place for the primary-care home, but I think how that space will function and how physicians will see their patients and take care of them will look different in the future.”

    A school nurse and a student at Morning Star Catholic School in Orlando, Fla., use Nemours’ telemedicine system to consult with a pediatrician as part of a wellness check.

    In 2014 Nemours began its telehealth program, a 24/7 on-call pediatric service offered in seven states that focuses on direct-to-consumer care for acute, chronic and post-surgical appointments. Patients can access clinicians via a smartphone or laptop.

    Officer said the early signs seem to indicate telehealth has helped reduce costs by lowering hospital utilization. A 2018 peer-reviewed analysis of Nemours’ pediatric telemedicine program published in Telemedicine and e-Health Journal that tracked 1,000 patient visits from October 2015 to June 2017 found that when surveyed, 67% of parents who used the health system’s telemedicine services reported they otherwise would have visited an emergency department, urgent-care center or retail health clinic had telehealth not been available.

    The study reported 27% of parents would have opted to visit an ED had they not used telehealth, which the analysis suggested would have saved the Florida healthcare system $113 million out of the $480 million the state spent in pediatric ER costs that year.

    Telehealth integration

    Shauna Coyne, director of innovation at New York-Presbyterian Hospital, witnessed telemedicine’s eventual integration into the regular way care is provided, becoming expected rather than being seen as a special additional service.

    Since 2016, New York-Presbyterian has conducted 160,000 telehealth visits through an array of services that include leveraging the expertise of its physician specialists from affiliate facilities Columbia University Irving Medical Center and Weill Cornell Medical Center to provide patients from around the country with second opinions on their clinical issues.

    Other offerings included the launch of the hospital’s ExpressCare, which allows patients who arrive at the ED with non-emergency issues to have virtual visits with a clinician to expedite their treatment. New York-Presbyterian also provides digital follow-up appointments instead of having patients come back for an in-person visit.

    “We think that by between 2023 and 2024 the number of virtual visits could surpass the number of in-person ambulatory visits,” Coyne said. 

    Like Nemours, Children’s Health System of Dallas developed its telehealth program as a form of triage that allowed the hospital to address the needs of lower-acuity patients who might otherwise show up in the ED.

    “We’re looking at it as a way to really allow kind of a clearance of those who do not have to be in the hospital and the clinic to be able to access their provider in other locations, whereas the sickest of the sick can be in the hospital,” said Tamara Perry, senior director of virtual health operations for Children’s Health of Dallas. 

    But the strategy of the Dallas system’s telehealth program has since expanded to providing virtual health services directly to area schools. The system began in 2013 with services in 27 schools and has since expanded into 118 across Texas, making it the largest school-based program of its kind in the country.

    Fewer sick people in clinics

    “We’ve identified places where there is a lack of care,” Perry said. She acknowledged that telehealth’s growing prevalence in healthcare would probably mean a change of focus for healthcare clinics—from places that primarily deliver sick care to facilities that individuals go to for wellness checks and preventive-care services.

    “I don’t see that the clinics will go away, but I do see that it will be a transition of what the clinics give and how they perform,” Perry said. “Maybe we’ll have more clinics that will be similar to fitness clubs and fitness centers.”

    Dr. Roy Schoenberg, CEO of Boston-based telemedicine provider American Well, acknowledged that most providers have traditionally perceived telehealth as a service for one-time care of minor conditions. But he said perceptions are changing. As healthcare providers begin to embrace virtual visits, Schoenberg said there is a growing acceptance that the delivery method will be an essential component of managing doctor-patient relationships moving forward.

    He said telehealth will offer an opportunity for hospitals to rethink how they operate to understand how they can perform better with the help of such technologies. But whether providers adapt or not, Schoenberg said one thing was clear: Change is coming.

    “Most everybody thinks of telehealth technology today as something that changes access, as a way of accessing healthcare more conveniently,” Schoenberg said. “What this technology brings to the table is the ability to completely redistribute healthcare altogether.”

    More on telehealth:

    Data Points: Telemedicine on the rise

    Commentary: Telehealth holds promise, but human touch still needed

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Teladoc reports $383.3M in fourth-quarter revenue, up 145%
    Teladoc reports $383.3M in fourth-quarter revenue, up 145%
    Oscar Health's $1B IPO sets the stage for more health tech exits in 2021
    Oscar Health's $1B IPO sets the stage for more health tech exits in 2021
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Minorities in Healthcare
          • - Luminaries
          • - Top 25 Minority Leaders
          • - Minorities to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Healthcare Transformation Summit
        • Leadership Symposium
        • Virtual Briefings
          • - Hospital of the Future
          • - Mental Health
          • - Patient Safety & Quality
          • - Strategic Marketing
          • - Virtual Health
          • - Workplace of the Future
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing