Excerpt from a new HBR article outlining the benefits of virtual care.

Telehealth

The Telehealth Era Is Just Beginning

“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.

How to Spur Adoption

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.

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The Wire

• Diligent Series B: Healthcare robotic automation startup Diligent Robotics recently raised $30M in Series B funding to accelerate the development of its socially-intelligent (and cute) service robots for the clinical setting. The flagship robot, Moxi, performs fetch-and-deliver tasks for frontline healthcare teams, such as delivering lab samples and collecting supplies. At a time when burnout and staff shortages are top of mind for nearly all hospitals, the new funding will help Diligent keep up with “skyrocketing demand” for its tireless mechanical employees.

• Email Warnings: Researchers at a large academic medical center recently flagged 444 employees for unauthorized access to protected health information (PHI), randomly selecting 219 employees to receive an email warning, while the remaining 225 employees served as controls. Only 2% of the employees in the intervention group committed unauthorized access for a second time over the following seven months, while 40% of the control group accessed PHI again. The results indicate that email warnings are highly effective in preventing repeat breaches from employees, and should be used to reduce risks related to unauthorized PHI access.

• Transcarent Oncology Care: Employer-focused healthcare platform Transcarent announced its expansion into cancer care with Transcarent Oncology Care, designed to connect employees with nearby cancer institutes, oncology providers, and clinical trials. Transcarent members can now search the Transcarent app for oncology and mental health resources for holistic support from diagnosis to remission. The new launch follows Transcarent’s $200M Series C round from earlier this year, which bumped the company’s valuation to $1.62B within a year of its March 2021 launch.

• Accessibility Requests: Patients are more likely to make accessibility requests with an EHR-based questionnaire than during an in-person visit, according to a new study in JAMA Network Open. Aftering examining data from 58k patients at the Johns Hopkins Wilmer Eye Institute, researchers found that 9.4% of all encounters involved accessibility requests, yet only 5.2% of patients made a request during their first visit. The authors of the study suggest implementing EHR-based questionnaires for accessibility requests across more clinical settings as a highly scalable way to improve the patient experience for those with disabilities.

• Blue Spark Growth: Remote monitoring company Blue Spark Technologies closed $40M in debt financing to support the marketing of its disposable temperature-tracking patch. The FDA-approved TempTraq patch provides continuous body temperature monitoring that gives healthcare providers a low cost way to monitor patients for fever spikes for up to 72 hours. It’s interesting to see the company opt for raising debt as opposed to giving away ownership in a venture round, although it wouldn’t be surprising to see more companies start going this route given the market’s recent repricing of healthtech startups.

• EHR Dissatisfaction: KLAS’ latest Clinician Turnover Survey of 59k clinicians found that those who are very dissatisfied with their EHR are nearly three times more likely to leave their organization over the next two years compared to those who are very satisfied with their EHR (34% vs. 12%). The researchers suggest addressing this issue by personalizing EHR training to individual workflows, given that only 14% of clinicians who strongly agreed that their EHR training matched their workflows plan on leaving (vs. 31% who strongly disagreed).

• Bright Health Refocusing: Bright Health recently announced plans to exit six underperforming markets as it starts to reign in its quickly mounting losses. The insurtech company will no longer offer coverage in Illinois, New Mexico, Oklahoma, South Carolina, Utah, and Virginia after 2022, and will instead pursue growth in California, Texas, and Florida. Bright Health went public last June at a valuation of nearly $1B, then reported a full-year loss of $1.2B in 2021. Given that the soon-to-be-former markets account for less than 5% of the company’s overall business, it’s likely that we’ll see more “refocusing” in the coming months.

• Outpatient Experiences: The Leapfrog Group published its Outpatient Surgical Care Report, finding that patient experience scores were higher for ambulatory service centers (ASCs) than hospital outpatient departments (HOPDs) over the course of the pandemic. Although patients gave favorable responses about the facilities and staff for both ASCs and HOPDs (97% vs. 96.6%), over 87% of ASC patients were willing to recommend the facility, compared to 82.4% of HOPD patients. Although the results clearly favor ASCs, Leapfrog stated that few ASCs voluntarily complete experience surveys and provide the results to CMS, potentially biasing the results and highlighting a need for more transparency.

• Providence CDO: Providence Health named Sara Vaezy as executive vice president and chief digital officer one month after the role was left vacant following the departure of Aaron Martin, who left to serve as Amazon’s vice president of health. Over the past few years, Providence’s Digital Innovation Group has spun off several notable companies including DexCare and Xealth, and now Vaezy will look to continue the momentum at the helm of the health system’s digital strategy and product innovation teams.

• Health System Challenges: A recent survey of 75 health system executives from Advis found that the largest challenges currently faced by respondents are staffing shortages and rising costs. Over 90% of respondents said they’ve increased compensation to help recruit staff, while 81% reported that they are filling labor gaps with outside agencies. The need for more relief funds was apparent in the results, with 70% of the execs continuing to seek federal assistance to help offset their heightened expenses.