“The Telehealth Era Is Just Beginning” is a fitting title for the bullish stance on virtual care featured in this month’s issue of the Harvard Business Review. Although we cover plenty of articles outlining the benefits of telehealth, this piece was penned by a pair of especially qualified authors: former chief executive of the Permanente Medical Group, Robert Pearl, and Intermountain Healthcare’s executive director of telehealth services, Brian Wayling.
Pearl and Wayling shared an extensive deep dive on several key areas where telehealth can have a positive impact. It’s worth the read if you have 30 minutes and a big cup of coffee, but the key points are outlined here for those in search of the condensed takeaways.
Reducing unnecessary trips to the ER was the first focus area, due in large part to the heightened medical risks created by ER physicians frequently lacking access to patient EHR data and the low likelihood of follow-up care.
- Kaiser Permanente addresses these issues by providing members with a telehealth center with physicians that can solve the problem and coordinate any follow-ups in 60% of cases, preventing unnecessary ER visits.
Reversing the chronic disease crisis was the second use case highlighted, with telehealth providing a better way to serve the 50% of US hypertension patients living with an elevated risk of complications due to poor management of the condition.
- Pearl reported that KP consistently achieves a blood pressure control rate above 90% by replacing traditional office visits with EHR-connected blood pressure cuffs and virtual check-ins, enabling more frequent disease measurement and timeliness of treatment.
Other interesting examples revolved around improving access to specialty care and reducing geographical barriers to treatment, which help eliminate misdiagnosis and long wait times for patients with rare conditions.
- Wayling laid out how Intermountain’s Neuro Fast Access Clinical Team virtual platform allows low-acuity patients to receive remote migraine treatment from an expert, which opens up clinical time for patients who require in-person care.
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While these case studies are useful for anyone looking to replicate the success of KP and Intermountain at their own health systems, the article saves its most valuable information for last, exploring two changes required to usher in “the telehealth era.”
- Integration – The organizations that consistently rank highest on quality are large multispecialty medical groups that leverage technology to coordinate care. As more doctors opt to work within health systems, they’ll be able to take advantage of shared EHRs, cross-specialty communication, and virtual care to help patients in ways unavailable to physicians in solo practice.
- Value-Based Care – Doctors who are incentivized based on the quantity of services they provide will logically resist models that reduce specialty referrals and hospital admissions. It’s easier for KP and Intermountain to say this, but telehealth’s full benefits will only be realized after more organizations adopt value-based structures that promote the use of virtual care to create superior outcomes.
For best results, Pearl and Wayling suggest implementing value-based models within integrated organizations, driving the point home with a final example of how two large health systems (good luck guessing which ones) are finding success with this strategy.