Virtual care is undoubtedly on the rise, and telehealth programs are popping up in hospitals around the country. But as the hype grows, health systems need to ensure they’re reaping a financial benefit from the implementation of such initiatives.
At the AVIA Network Summit in Chicago in late May, three leaders discussed the economic case for their organizations’ virtual health programs.
Chicago-based Northwestern Medicine teamed up with InTouch Health to put a telestroke program in place.
“Today our telestroke program uses a hub and spoke model,” said Jodi Rosen, Northwestern Medicine’s director of innovation. “We have found it to contribute to provider satisfaction as we are enabling care and providing a level of support for our stroke hospital emergency department physicians that they would otherwise not have. We have also seen positive clinical outcomes and quality metrics on behalf of the patients whose lives are touched by our telestroke offering.”
Rosen noted that her system focuses on the business case in the early planning stages of implementing a virtual care program. Rather than chasing the device or technology, she said Northwestern first seeks to understand the problem.
St. Luke’s University Health Network in Fountain Hill, Pennsylvania, also prioritizes forethought. Its director of innovation and strategic partnerships, Matthew Fenty, said the network spent about two years looking at vendors, understanding the reimbursement side and examining the clinical governance before putting an initiative in place. St. Luke’s ended up working with American Well and staffing its program with its own urgent care physicians. The project has been live for two years.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
As for the ROI side, Fenty said it’s clear that “the economic business model of yesterday doesn’t quite fit.” To that end, he noted St. Luke’s is having discussions with the local payer market about reimbursement of telehealth services.
Greenville Health System, headquartered in South Carolina, is harnessing technology to meet its needs as well. However, it’s using Bright.md’s SmartExam tool, an asynchronous solution. Instead of meeting face-to-face with a physician, a patient enters all his or her symptoms into Bright.md’s portal by answering a series of questions. The solution takes all the patient’s information and puts it up against evidence-based guidelines. It then presents its findings to a provider, who is able to make the final call.
Blix Rice, vice president of innovation and transformation at Care Coordination Institute, shared a success story of a patient who used SmartExam and was eventually routed to a provider. The patient did not have a primary care provider, and instead planned to go to the emergency department for care. But with the advice of GHS providers, the patient ended up going to a mobile clinic instead of the ED.
“Even though in that case, that particular asynchronous modality didn’t solve that person’s problem, it was an agent of solving that person’s problem,” Rice said.
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