An analysis of claims data by Fair Health released as a white paper in July 2019 showed that from 2014 to 2018, usage of non-hospital-based provider-to-patient telehealth grew more rapidly in urban areas increasing 1,227 percent compared to 897 percent in rural areas. The opposite was shown, however, for discharge-related provider-to-patient telehealth claims that showed 407 percent increases for rural areas compared to 157 percent for urban patients.
Less surprising is that patients ages 31-40, accounted for 21 percent of all telehealth claims, while 82 percent of claims were made for patients 51 and older. Conditions most frequently linked to telemedicine were for upper respiratory infections, mood disorders and anxiety.
The number of physicians providing telehealth is growing too with those reporting telemedicine as a skill rising 20 percent over the past three years, according to a 2019 report by Doximity.
While many think of telehealth as a video consult between a patient and remote physician, in rural communities, it is more likely patients in their local doctor’s office or hospital will receive telehealth care from specialists in larger cities.
In a 2019 Harvard Business Review article looking at the telemedicine experience of patients of Intermountain Healthcare, a large healthcare system operating 24 hospitals and 160 clinics in
in Utah and Idaho. The provider uses secure video and audio technology to connect care providers in their smaller health care facilities with specialists in their large hospitals.
In addition, Intermountain provides 40 telehealth services in seven western states to many facilities that are not part of Intermountain. It offers a 24/7 telehealth center in Salt Lake City with a full-time staff, plus about 500 care providers on call who are in a wide range of medical specialties. Telehealth-connected specialists communicate directly with patients and local care providers and receive real-time updates on medical conditions.
As one example of how the telehealth system reduced patient care costs, the study cites the case of a baby born in a rural community with a hole in one lung. Using Intermountain’s 24/7 on-demand system, the baby obtained a critical care consultation that allowed him to stay in the facility where he was born instead of being transferred to a newborn intensive care unit (NICU) at one of Intermountain’s tertiary care facilities. That saved an $18,000 helicopter transfer, not to mention allowed parents to stay with their baby, saving them the expense of a 7-hour drive and perhaps several day hotel stay.
In an example of telehealth delivery in an urban area, Senior Helpers, a Baltimore-based in-home care organization, along with Capital Coordinated Medicine (CCM), a home-based primary care practice based in Maryland, collaborated on a pilot study of telemedicine with 33 older adults in their homes.
In the pilot study reported in Home Health Care News specially trained Senior Helpers home-care nurses served in the role of a “telepresenter” who assisted throughout the primary care visits with remote CCM physicians.
The results showed that telemedicine could be used to more regularly and affordably connect older adults with their doctors. Costs savings were 44 percent lower than traditional in-home visits.
In addition, more patients were able to stay in their homes, with seven patients, who otherwise would have been sent to the ER, receiving the treatment they needed at home via the home-care telehealth model. The study sponsors hope that model might overcome one the roadblocks to telemedicine, which is receiving reimbursement for care delivered by telemedicine. Currently, there aren’t clear pathways for reimbursement in terms of fee-for-service Medicare patients.
“If telemedicine is going to be a meaningful solution for high-need patient care, a friendly home care worker might be the best way to introduce it to the patients who need it most,” Michael Hughes, VP of strategic development for Senior Helpers, told Home Health Care News.
In both rural and urban settings, it is clear that the potential for telemedicine extends far beyond video consults for lab reviews, surgery follow-ups, or monitoring. Combined with trained onsite healthcare providers working with remote physicians and specialists, telemedicine offers the ability to provide clinical services that previously had been confined to office or clinic visits.
In-home healthcare providers armed with telehealth tools such as endoscopes, otoscopes, general exam cameras, camera-guided catheters used under guidance of remote physicians will expand the potential of telemedicine far beyond video conferencing to increasing access and improving care for patients at a lower overall cost.
As the technology and the number of providers comfortable with it advances and grows, the number of telehealth models will grow as well. Whatever models emerge it is clear that telemedicine is poised to cause a significant shift in the way healthcare is delivered in both rural and urban patients.
PercuVision LLC’s mission is to improve patient care and safety by applying microfiber-optic bundle technology to commonly invasive medical procedures. The DirectVision Telehealth Hub connects patients with specialists by supporting a wide range of professional examinations through an all-in-one built-in HIPAA compliant telemedicine platform solution. Contact us via phone at (614) 891-4800 or use our online contact form.