April 19, 2018

Tammy Bradly: In an On-Demand World, Telemedicine Can Be a Smart Call

Tammy Bradly, Vice President of Clinical Product Development, Coventry

Tammy BradlyFor many consumers, living the good life increasingly means living the on-demand life. We can do our banking or order up a car service in seconds with only our phones. Two-day delivery for goods, once the exception, is now commonplace. Music, books, and movies appear for our entertainment in an instant — no wait required.

Simply put, speed equals success. Consumers’ expectations for easy access to goods and services are spilling into health care, including workers’ compensation. Severe injuries have always demanded immediate attention, triage, and care. What’s new is a proliferation of telemedicine services that could one day rewrite standard operating procedures for how we deliver care to injured workers. For now, telemedicine accounts for a small but growing slice of how group health patients visit with a doctor. A number of forces, from the halls of government to corporate boardrooms, are aligning to promote telemedicine as a tool for quickly directing care to where it is most urgently needed. This support has important ramifications for treating injured workers.

Today we will provide some of the many examples of growth in telemedicine to gain insights into how these services could become more widespread in workers’ comp. In our next installment, we’ll dig deeper into how telemedicine services are taking shape in workers’ comp.

CoventryBefore discussing growth in care delivered through virtual visits, it would be helpful to make distinctions between telemedicine and telehealth because both terms have currency. Telemedicine refers to using electronic communication technologies such as video conferencing to improve a patient’s health status by connecting her with a health care provider in another location. The exchange of information might occur through phone calls, video chats, or email. While many observers use telemedicine and telehealth interchangeably, some distinguish telemedicine as service delivered by a physician and telehealth as care delivered by a nurse, pharmacist, or other health professional.

Regardless of the terms they use, many decision-makers in health care are looking to technology as a tool for broadening access to care. A recent survey of more than 100 leaders in health care organizations found 56 percent had a telemedicine platform and that about a quarter of those entities without a system are examining their options for incorporating telemedicine. The poll, released by the research firm Sage Growth Partners in 2018, also indicated nearly three-quarters of respondents expect to increase spending on telemedicine within the next year.

Most enterprises expect to tiptoe into telemedicine as the technology matures though some plan to make a bigger push. Nine percent of the leaders in the survey predict that more than a quarter of patient encounters will occur though telemedicine within three years.

CoventryMany of us will be ready. A recent Ernst & Young survey found consumers are eager to share data virtually as a means of saving time and money. More than half of the nearly 2,500 consumers the consultancy polled were ready to contact their physician digitally. About one-third were interested data-sharing and at-home diagnostic testing. And 21 percent were interested in video consultations.

Businesses and consumers aren’t the only ones eager to see growth in telemedicine. The federal budget agreement that President Trump signed in February included dozens of provisions related to health care. Among them was a change that allows Medicare Advantage plans to offer telehealth services as part of the basic benefit package starting in 2020. Other aspects of the deal include expanded reimbursement for use of telehealth for conditions such as stroke.

Beyond Capitol Hill, some of the biggest champions of telehealth are those looking to build upon early success with the technology. The Cleveland Clinic logged more than 25,000 virtual visits just last year through an app that lets clinicians and patients interact by video. The number of visits was more than double what the health system saw in 2016. The Cleveland Clinic regards telehealth as its fastest-growing clinical offering — one that allows it to “provide care for a variety of conditions anywhere on earth.”

The U.S. Department of Veterans Affairs has pioneered what it terms clinical video telehealth to make diagnoses, oversee cases, conduct check-ups and provide care in more than 45 specialties. The agency’s top telehealth services include mental health and rehabilitation in areas like audiology and speech pathology. Other top services include retinal imaging, primary care, weight management, cardiology, and dermatology. All told, the VA saw more than 677,000 veterans, or about 12 percent of its patients, via telehealth in its 2015 fiscal year. The agency announced in 2016 it would expand its telehealth offerings.

CoventryThere are instructive examples of telemedicine being used to plug potential gaps in service. A New Jersey company that runs long-term care facilities turned to a telemedicine provider to make physicians available for consultations during evenings, weekends, and holidays. The aim was to improve care and reduce unnecessary trips to hospital emergency departments. In Utah, a health system strung together 35 telehealth programs to extend specialty care to rural hospitals that otherwise wouldn’t be able to offer such services. Even big players that can offer a full spectrum of specialty care and provide off-hours staffing are getting into telehealth. NewYork-Presbyterian/Weill Cornell Medical Center’s emergency departments in New York City sometimes use telemedicine to evaluate patients. Following triage, eligible patients are given an option to move to a private room to see a doctor remotely. The effort has reduced wait times and lowered the number of patients who walk out in frustration before seeing a clinician.

Many businesses, hospital systems, government agencies, and consumers are willing to embrace telehealth because they expect the technology will drive efficiency and broaden access to care. In 2017, the RAND Corporation reported that the ease of using telehealth can make consumers more likely to seek care. The nonprofit research institution reviewed claims data for 300,000 people in California. RAND estimated that 12 percent of telehealth interactions replaced a visit to another provider whereas 88 percent appeared to be meeting unmet demand for care.

CoventryIn workers’ comp, telemedicine could offer benefits in the critical area of trust. Employers that give injured workers options for obtaining care beyond in-person visits can drive home the idea that management cares about and is interested in a speedy recovery for the employee. The Workers Compensation Research Institute (WCRI) identifies trust as an important predictor of outcomes for injured workers. Those workers who believe their employer cares for their wellbeing do better than those workers who, for example, are fearful of losing their job. Workers who have more avenues for obtaining care and beginning their recovery could feel that critical sense of concern from an employer.

There are other ways telemedicine could benefit the workplace and even those workers who aren’t injured. The direct-to-consumer telemedicine company Teledoc® reported its membership surged and visits jumped by 49 percent in the final quarter of 2017 compared with a year earlier. Concern about the virulent flu strain that recently pushed some hospitals to pitch overflow tents in parking lots led some consumers to consider telehealth. It was a way to obtain care without the risk of infection that a visit to a health care provider might bring. Consider what a sick worker might spare a worksite if he could meet virtually with a doctor from home. A person who was assessed via video or phone while at work could obtain immediate care for an illness that could spread to others and perhaps leave before infecting others on the job site. Knowing sooner that it was time to leave work would be good for everyone.

The growing use of telehealth services to achieve a variety of goals makes clear there is widespread interest in this means of accessing care. It appears our on-demand society is only contributing to its growth. In workers’ comp, broader use of telehealth could offer another way to bring injured workers back to good health and to the job. We’ll take a closer look in our next installment.

About Tammy Bradly
Tammy Bradly is vice president of clinical product development for Coventry. Bradly is a certified case manager with more than 25 years of comprehensive industry experience through service delivery, operations management and product development. She holds several national certifications, including certified case manager (CCM), certified rehabilitation counselor (CRC) and certified program disability manager (CPDM).

About Coventry
Coventry offers workers’ compensation cost- and care-management solutions for employers, insurance carriers and third-party administrators. With roots in both clinical and network services, Coventry leverages more than 30 years of industry experience, knowledge, and data analytics.

Disclosure:
Coventry is a WorkCompWire ad partner.
This is not a paid placement.

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