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.”