How telehealth can get healthcare to more people

doctors 2019

(Unsplash, 2019)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Vitor Rocha, CEO, Philips North America


Growing up in Belo Horizonte, Brazil, I saw firsthand that where you live is often the single greatest determinant of health and life expectancy. In Brazil, 75% of the population does not have private health insurance. Long lines at outdated public health clinics for the most basic services are a normal part of everyday life.

After university, graduate school and with a decade of professional experience under my belt, my career brought me to the US. In 2001, my wife and I were blessed with twin daughters, who were born prematurely. Thankfully, we lived in Erie, Pennsylvania at the time, not in Belo Horizonte. Our daughters received the best possible care any parent could ask for, at the University of Pennsylvania Medical Center Hamot.

The stark contrast to the type of care they might have received in my hometown is etched in my heart and mind. As a father, I am deeply grateful. As a professional who has spent a career in healthcare, I am struck by how much work remains to be done on access and inclusion. Not only in Brazil, but also in the US.

Despite being at the forefront of medicine and spending 18% of GDP on healthcare – almost twice that of other developed countries – most Americans are no healthier for the investment. Access to care remains a privilege. Overall, according to the most recent Philips Future Health Index, the value and efficiency measures of US healthcare are below average for the 16 countries covered by the index. In that regard, the US has a lot in common with Brazil, and with other markets with large populations such as India and China.

We find ourselves in a history-making dichotomy: though medicine advances, the life expectancy rate in the US is declining. The reality is that one’s zip code remains a major determinant of healthcare, with people just one postal code away from a vastly different opportunity at longevity, as evidenced by a 2017 analysis across US geographies.

Typically, in urban areas healthcare boasts some of the world’s most innovative applications of technology; offers care from the most sophisticated clinicians; and pioneers advanced research that could affect billions of lives. Other zip codes are plagued by infrastructure challenges and lack of access to treatment and medical products. Nowhere is this more true than in areas separated by distance, income and opportunity.

As the United Nations calls for universal healthcare by 2030, the challenge in the US alone may seem intractable. America’s sprawling geography, temperate climate and topography have made it possible for the population to spread into all sorts of plains, nooks and crannies, rather than cluster in a few habitable pockets. That distribution, which has been a boon to agricultural, industrial, and cultural diversity, has presented a particular challenge to healthcare that is only intensified by the current transition from a fee-based to value-based model. How do we seamlessly deliver high-quality care to more people in more places, and do it at a lower cost?

Just like how the transcontinental railroad “solved” America’s geography challenge generations ago, telemedicine is seeking to solve the zip-code-driven challenge of healthcare access now. With the more data-driven and connected approach promised by telehealth technologies, healthcare delivery will no longer be tied to particular locations or structures.

Telehealth – the provision of healthcare remotely through telecommunications networks – can extend the reach of healthcare to places like the home, as well as remote or formerly underserved areas. It can also connect physicians with each other, allowing for faster diagnosis and enabling expertise to break free of organizational or geographical binds. In other words, the train has arrived – we just need to get all aboard.

Early results indicate the engine is beginning to chug along. The Philips Future Health Index also shows rates of adoption of “remote patient monitoring” services are much higher in the US than in other Western countries with comparably sophisticated healthcare systems. Remote patient monitoring is an emerging field that combines interconnected equipment and data analytics applications, allowing for high-quality care of patients outside typical clinical settings.

The Philips Future Health Index

One major healthcare institution that has seized the telehealth opportunity is the US Department of Veterans Affairs (VA), now operating the largest telehealth programme in the country. Last year, more than 700,000 veterans participated in telehealth services through the VA.

Men and women from urban Houston to rural Idaho received check-ups and counselling from desktops, tablets and smartphones; diagnostic metrics were delivered through secure, high-speed internet; 300 providers were connected through 67 VA hospitals and clinics, offering 50 clinical specialties, from dermatology to intensive care. Instead of travelling three hours to visit their care providers, these veterans are travelling an average of 15 minutes and the care is receiving high marks. Veterans gave these telehealth services satisfaction scores ranging from 88-93%.

Those statistics may be about to spike. Veterans all over the country may soon be conducting their medical appointments virtually with telehealth technologies, in venues they find almost as familiar as the home itself – local posts of the Veterans of Foreign Wars and the American Legion.

Other healthcare systems boarding the Telehealth Express include Westchester Medical Center Health in New York’s Hudson Valley, which is using telepsychiatry to reduced missed patient appointments by 30%, as well as providing access to behavioural health services for students in rural Delaware County through Margaretville Hospital. Emory Healthcare in Atlanta has saved more than $4.6 million by reducing stays and re-admissions among rural Georgia intensive care patients.

Avera eCARE’s virtual hospital reaches across 16 states and nearly 400 communities, serves 13% of the nation’s critical access hospitals, and partners with hospitals, clinics, schools, long-term care communities and correctional facilities. Finally, Northwell Health is using telehealth for behavioural health and stroke care. It recently expanded the programme by partnering with LiveOnNY to use their tele-intensive care unit to support organ donations, increasing organ referrals by about 121%, timeliness by 9.5% and donations by 33.9%. Each of these organizations has deployed telehealth strategies that reduced cost while increasing effectiveness and efficiency.

 

So if telehealth is such an obvious solution to the problem of healthcare access, why has it not been adopted as readily as the railroads were in the 1800s? There remain multiple barriers.

First, the financial case. Insurance reimbursement models are built around physical visits. When reimbursement policies begin to assume that telehealth visits are “real” medical appointments, adoption will increase. This financial incentive is crucial. After all, the engine driving the completion of the transcontinental railroad was the discovery of gold in America’s West.

Second, a robust broadband infrastructure necessary to convey great volumes of data is not universal. Some US regions are wired “hotter” than others, a disparity that favours cities over rural areas.

Third, some of the cost savings inherent in telehealth technologies must accrue to the patients – not just providers and hospitals – to incentivize patient preference.

Fourth, there is a need for standardization of information formats so that data collected via one telehealth system in San Diego can be compared or integrated with data collected in another in Charleston.

Finally, we wait for healthcare regulation, which is managed state by state, to catch up to the geographically agnostic technology of telehealth. There is no reason why the VA’s recent super-state telehealth rule could not be extended beyond the government sector.

We have the technology, the data, and the adaptive intelligence tools to make sense of the data, to help reduce cost and improve patient outcomes. With the statistics and proof that telehealth works, what is holding us back? What can or should be done to advance it? While telehealth may not be the whole answer to the challenge of access, it will help lay the tracks.

Ultimately, it will take patients, providers, payers, government and non-profits to align with the idea that healthcare should be more seamless, more preventive, and in this case, more virtual. We all have a role to play in getting this train to its destination. The engine is primed. It’s time to get aboard.

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

New EU rules ensure better protection for 120 million holidaymakers this summer

European Border and Coast Guard: 10 000-strong standing corps by 2027

Google succumbs unconditionally to EU’s “right to be forgotten” ruling

COVID-19 will hit the developing world’s cities hardest. Here’s why

Tributes for ‘role model’ former UN refugee agency chief, Sadako Ogata

The big five EU telecom operators in dire straights

AI can wreak havoc if left unchecked by humans

Clamp down on illegal trade in pets, urge Public Health Committee MEPs

As conflicts become more complex, ‘mediation is no longer an option; it is a necessity’, UN chief tells Security Council

We are ‘burning up our future’, UN’s Bachelet tells Human Rights Council

Hydrogen isn’t the fuel of the future. It’s already here

5 ways COVID-19 has changed workforce management

Terrorism and migrants: the two awful nightmares for Europe and Germany in 2016

EU job-search aid worth €2 million for 500 former shipbuilding workers in Spain

France pushes UK to stay and Germany to pay

Where EU air pollution is deadliest

China rare earth prices soar on their potential role in trade war

Harmonised Unemployment Rates (HURs), OECD – Updated: February 2020

UN spotlights wellbeing of seafarers on International Day

‘Much more’ can be done to raise awareness about the plight of persons with albinism: UN chief

UN-backed intercultural dialogue forum urged to keep working to ‘bridge gap between the like-minded’

EU joint response to disasters: deal reached with Council

Combatting terrorism: Parliament sets out proposals for a new EU strategy

This South Korean city once had the biggest coronavirus outbreak outside of China. Now it’s reported zero new cases

Commission moves to ensure supply of personal protective equipment in the European Union

5 crises that could worsen under COVID-19

Finland has just published everyone’s taxes on ‘National Jealousy Day’

ITU Telecom World 2017: exploring smart digital transformation

European Parliament calls on Russia to end occupation of Georgian territories

5 neuroscience hacks that will make you happier

RescEU: MEPs vote to upgrade EU civil protection capacity

All for equality – 2020 is a pivotal year for Gender Equality

Deeper reforms in Korea will ensure more inclusive and sustainable growth

UN Climate Action Summit concludes with insufficient EU and global pledges

Milk, fruits and vegetables distributed to schoolchildren thanks to EU programme

China’s cities are rapidly becoming more competitive. Here’s why

Security Council must ‘come together’ to address the plight of children trapped in armed conflict, says UN envoy

EU Migrant Crisis: Italian Coast Guard Headquarters and Italian Navy to give host national opening addresses at Border Security 2016 in Rome

New EU-UK agreement is welcome but thorough scrutiny remains, insist lead MEPs

Coal addiction ‘must be overcome’ to ease climate change, UN chief says in Bangkok

EU27 leaders unite on Brexit Guidelines ahead of “tough negotiations” with Theresa May

How to get young people in Europe to swipe right on voting

This is Amsterdam’s ambitious plan to turn its transport electric

Reforms in Latvia must result in stronger enforcement to tackle foreign bribery and subsequent money laundering risks

Parliament boosts consumer rights online and offline

What is systemic racism, and how can we combat it?

EU Council approves visa-free travel for Ukraine and cement ties with Kiev

Powering a climate-neutral economy: Commission sets out plans for the energy system of the future and clean hydrogen

Marginalized groups hit hardest by inequality and stigma in cities

OECD joins with Japan to fight financial crime by establishing new academy

The business case for diversity in the workplace is now overwhelming

EU Parliament and Council: Close to agreement on the bank resolution mechanism

Poor quality is healthcare’s silent killer. Here’s what we can do about it

ECB asks for more subsidies to banks

Global trade is broken. Here are five ways to rebuild it

Intervene, don’t overthink – the new mantra of systems design

We need natural solutions to fight ocean and climate risk

EU Parliament: No EU-US trade agreement without safe data

The MWC14 Sting Special Edition

Italy and Greece zeroed their fiscal deficits, expect Germany’s response

More Stings?

Advertising

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s