For decades, established providers of healthcare services have been the preferred “in-network” providers for health plans. But there are new competitors in the market, such as retail walk-in clinics, free-standing emergency rooms and telehealth direct-to-patient service providers. These seemingly quiet competitors are in actuality national healthcare service providers such as the telehealth direct-to-patient service providers, telehealth service companies who are signing direct contracts with health plans and employers, siphoning off patients who traditionally would have been seen by their preferred in-network providers.
These national telehealth service companies are reaching deeper into the market as they begin to offer new primary and specialty care services. As a result, when these telehealth service companies secure patients, they are also potentially disrupting the natural flow of referrals that typically occur within health systems. Ironically, the telehealth service companies – which are increasingly in direct competition with health systems – want these same health systems to pay them to license their software to facilitate virtual care services with their own patient populations, at times suggesting their contracted, out-of-network doctors as care providers.
As these new healthcare service providers increase their presence in the market, established medical groups, hospitals and health systems need to reconsider their models for delivering care. Where national telemedicine service companies are concerned, their services can be a “Trojan horse” disguised as a partner, while actually encroaching on current patient populations. As established providers adjust their care delivery models to current market realities, they need to take a step back and develop a comprehensive digital health strategy that is effective across the enterprise of services and across the care continuum, delivering the highest value services with the greatest access and convenience.
As part of that digital health strategy, telemedicine should be seen as not an end in itself, but rather an enabling technology that can help providers better engage patients and maximize care and efficiency. Telemedicine should not be considered a separate practice, but as a complement to existing care models fully integrated into the healthcare provider’s toolbox. Only this approach will preserve the trusted relationships between providers and the patients and communities they serve.
Today, a new breed of enterprise virtual care software solutions is emerging that can enable medical groups and health systems to extend their services by putting the tools of telemedicine in the hands of a primary care or specialty physicians and affiliated care teams. While numerous health systems have launched pilot programs deploying a variety of telemedicine technologies, relatively few have developed comprehensive programs supporting multiple service lines with an enterprise software solution. As a result, these initial trial programs struggle to build momentum, and also present technology management challenges to the IT staff.
Enterprise solutions are different. They offer all the features and functions to practice any form of medicine suitable for virtual care, leveraging the existing staff of health systems and medical groups, as well as integrated outside care teams. Unlike the telehealth direct-to-patient service companies who compete with established healthcare providers, the purpose of these software platforms is to help healthcare systems and medical groups offer telehealth services to their patients, under their own brand, using the clinicians they approve and assign.
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.
In the current world of value-based care, comprehensive and integrated care delivery must include a powerful digital health strategy utilizing virtual visits as a core component. To remain competitive in today’s healthcare marketplace, providers must be wary of the “Trojan Horse” appearing in the form of telemedicine direct-to-patient service companies. They can mitigate that risk by taking advantage of the new best-of-breed telemedicine enterprise software solutions that can enable them to leverage their existing medical staff while improving patient access to convenient and high-quality care.
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