To bring in telemedicine, do homework and meet the patients – and health system CEOs – where they are

By Heather Mack
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As fun as FaceTime or other video calls can be, many people may choose to decline an incoming face-to-face chat for the simple reason of, well, not wanting to show their face. Understandably, when people are sick and are choosing to engage with their doctor virtually, they may not leap at the choice of a video visit.

“When we talk about telemedicine, a lot of people immediately think video. But when you look at modes preferred, most are not even willing to use video. In fact, half would choose a modality that specifically does not include it at all,” Dr. Kevin Smith, chief clinical officer at Zipnosis, said during a presentation at the American Telemedicine Association conference in Orlando.

And they aren’t eschewing the technology for complicated reasons, either, Smith said.

“In our company, we’ve done lots of testing with groups and done lots of polling, and many testers are mainly opting out of video for things like ‘what I’m wearing,’ or ‘what my hair looks like.’ Those are the top reasons.”

But providers and health systems need not put the brakes on bringing telemedicine into their practice for fear of alienating their patients, Smith said. Most patients are more than happy to use virtual visits, and, just like their aversion to the in-your-face approach of video, most even prefer it over a real human doctor.

“In our studies, we saw 70 percent of patients who would use telehealth over human ,” Smith said. “That can be a bit sobering for physicians, but the fact is they are not nearly as loyal to our in-person relationship as we believe them to be.”

But it’s not personal. Cost savings and convenience are the main reason, even with older patients, whom many innovators may write off as tech-phobic, but are in fact the largest users of telehealth because, as Smith said, they are the people using the most healthcare services.

So when providers want to bring in telemedicine, Smith advised, it’s important for them to do their homework and make sure they are meeting patients with the technology they actually want to use. In Smith’s own research, he found patients vastly prefer email, phone calls and e-visits – a mix of online check-ins and patient-provided data and follow-up calls, emails or texts. Accordingly, satisfaction levels with the telemedicine modalities are on par with the patients’ initially stated preferences.

Once providers figure out what their patients want, then it’s onto how exactly how to intelligently bring telemedicine into their practice. Alex White, a consultant at KPMG, explained how telemedicine could be used to grow revenue and increase efficiency in ways that simply hiring more doctors can’t.
“We have to put telemedicine in broader context of growth strategy. When we are talking about delivering on a supply side of physicians, we can see how health systems may or many not be able to act on this demand,” White said in a presentation. “And it is clearly and definitely proven that we have to find out what consumers want before bringing in technology.”

To illustrate his point, White describe two hypothetical health systems. One hires more doctors to grapple with more patients than they could previously handle. The other brings in telemedicine to extend the reach of their existing physicians.
 
“You have one hospital CEO who says the way out of a problem is to grow, which will lead to economies of scale. Then you have another who wants to drive patient loyalty and physician productivity,” White said. “But the first one will most likely get is more patients, so the problem doesn’t change and you now have more costs associated with those extra physicians and the promotion of their extra services. Not only are you just as inefficient as ever, you are losing more money.”

Of course, there may be situations when health systems do have to hire more doctors, but at the same time, they should start thinking about operating models that could drive productivity, White said. That means taking polls, like Smith said, and figuring out what patients want and which modalities deliver the best engagement and outcomes.

“I don’t know why, but very few health systems are using CRM and they really should be. You need to be able to strip out noise and figure out ways to reframe telemedicine access programs in ways the CFO, CEO and COO will understand,” he said. “That means explain how you will grow, emphasize the lifetime value of retaining a patient, and not canonizing the in-patient visits.”

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