Telehealth 2013
Piecing the Puzzle Together

Worth Knowing

Five Telehealth Disciplines Rise to the Top—Of responding providers, 78% were using telehealth in at least one of the following disciplines: home monitoring, psychiatry, stroke, neurology, and ICU. These same five will receive most of providers’ future investment. There were 33 other disciplines mentioned, ranging from education to humanitarian missions.

Home Monitoring Is the Most Prevalent Telehealth Discipline—Philips and Honeywell were the most used vendors for home monitoring devices. McKesson was also mentioned as providing both home monitoring and a homecare EMR. Despite high usage, satisfaction with home monitoring is relatively low due to poor patient adoption and a lack of EMR integration.

Cisco, Philips, and Polycom Lead the Market—Cisco and Polycom, with their videoconferencing carts, cameras, and infrastructure, were two of the most used telehealth vendors among a wide array of disciplines. Taking all disciplines into consideration, real-time videoconferencing interactions between clinicians and patients is the most popular technology. When it comes to eICU, 66% of provider organizations were using Philips’ (VISICU) carts and software.

Bright Future Ahead—Of providers doing telehealth today, 85% reported satisfaction with their results and 81% plan for future telehealth investment. Home monitoring and psychiatry are positioned to grow the most, and providers indicate vendors like Cisco, Philips, and Polycom, as well as InTouch (telestroke solution) and Vidyo (videoconferencing software), will help them. Providers also plan to incorporate Cerner (mentioned by 6% of respondents) and Epic (mentioned by 10% of respondents) into their telehealth strategies.

Funding: The Key to the Floodgates

Funding and ROI justification were providers’ biggest barriers to telehealth. Currently, the funding and sustainability model is based on organizations’ operating budgets, waning grants, and few payer reimbursements. One provider stated, “Telehealth could be much more successful if CMS and others would just make it a billable consult. . . . It won’t grow at the rate it has to grow at until this reimbursement model is fixed.” Providers are looking for more reliable funding sources for these projects, and it is clear to many that reimbursement is the key that will open the telehealth floodgates of adoption.

EMR Vendors Focused on Other Priorities

No single EMR vendor has established themselves as a telehealth leader. Although some providers expect EMR vendors to offer telehealth functionality in the future, many feel these vendors are currently too distracted by other considerations like meaningful use and ICD-10. Stated one CIO: “[Our EMR vendor] has too many other priorities to be focused on telehealth. Frankly, I am not aware of any EMR vendor that is thinking about telehealth right now.” Providers view the EMR vendors as one piece of the telehealth puzzle that still needs work. There were several instances of providers using Cerner’s or Epic’s EMR for documentation purposes, though Cerner and Epic scored higher primarily because of customers’ expectations of future development.

Telehealth Strategy: Much More Than Just Technology

Of provider organizations, 22% stated that developing a strategy is one of telehealth’s key challenges. There are numerous pieces of the puzzle that providers have to think through: from understanding payment structures and funding, to determining appropriate solutions and technologies, to implementing and ensuring both provider and patient adoption, to measuring outcomes. One provider explained, “Buying the system is more like 5% of the work. We have a telehealth project coordinator here . . . [and] she is spending time developing flow charts, care protocols, and sort of the standard work instructions for the people who will be handling different parts of this service.”

Writer
Jonathan Christensen

Project Manager
Robert Ellis