TELEHEALTH:
Connecting Health Care and the Public Sector INDUSTRY PERSPECTIVE
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INTRODUCTION Health care in America has long been a subject of debate. Efforts to improve care, as well as medicine and its delivery, are continuous. But there’s a new shift evolving today that puts the focus on patients, and it’s powered by technology.
Telehealth –
The transfer of electronic medical data, including sharing electronic health records, remote monitoring or store-andforward technology.
Telehealth is revolutionizing care delivery and increasing collaboration amongst the entire care team to provide better care and even reduce costs for patient and provider. Telemedicine – a term that is used interchangeably with telehealth – refers to live interactions between clinicians and patients. This is important because it means that live interaction is no longer synonymous with in-person appointments. Health care can be practiced in many cases as effectively via telehealth and telemedicine as traditional in person visits. Telehealth brings the expertise to patients rather than forcing them to seek it out. As a result, health care becomes accessible to populations that otherwise have trouble accessing it. Technological advancements and falling prices are converging to make now the right time to implement a telehealth program. To better understand what telehealth enables, the challenges and benefits that come with it and how it works in the real world, GovLoop partnered with collaboration expert Polycom and its Global Director of Health Care, Ron Emerson, for this industry perspective. Ahead, you will learn about the changing health care landscape, what it means for government agencies and how to apply lessons learned to your own telehealth program implementation.
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TELEHEALTH, THE GREAT ENABLER Besides technology and costs, several trends affecting health care are helping to make the case for telehealth. They include: kk A shift from treating ill people to preventing illnesses, which also reduces costs in the long run kk Prevention and wellness, including reducing re-hospitalizations and increasing population management kk Patient-centered care kk Practitioner shortages, leading to an increased demand for all levels of health care professionals kk Rising costs kk An aging population kk Chronic disease kk Home health care Within those trends lie challenges. For example, enabling patient-centered care requires medical team collaboration, while reducing unnecessary re-hospitalizations necessitates better hospital discharge planning, continued care coordination, medication management and follow-up visits. Implementing prevention and wellness programs – whether general or targeting a specific population that’s at a higher risk for a particular disease – also presents challenges, such as finding effective outreach methods. Telehealth and telemedicine further evolve those trends and help solve those problems. Video in particular is changing the game, whether medical professionals use it to hold virtual meetings about care planning or patients use it to get face time with their providers from the comfort of their home or office. “When you look at the landscape of health care, it’s moving away from just pure fee-for-service interactions with health care professionals to what we call population-based health. Population-based health is really about how we don’t just fix things when they’re broken,” Polycom’s Emerson
said. “Instead, we’re looking at how from the front end we can change behaviors, we can assess, we can have interactions with patients wherever they’re located – home or work – and how we can change those behaviors so we don’t have the development of chronic disease.” When initiating a program, every organization faces three main challenges, Emerson said: defining who the program will serve, whether the care will be high-quality and showing how telehealth can reduce costs and increase care and revenue by reaching new markets. “Any program we develop, we think, ‘Will patients like this?’ because that’s who we’re here to serve,” Emerson said. “That’s the first thing: patient satisfaction. And the good news is for telemedicine usually those numbers are always above the 90th percentile.” Proving clinical efficacy is also crucial. “If it’s a doctor seeing a patient over telemedicine from a distance, can we provide good clinical efficacy and quality care? We can show studies in many clinical areas that help prove it is quality care to physicians, so they feel comfortable utilizing the technology,” he said. As for a business case, despite initial setup costs, telehealth can save agencies money in the long run. It does this in two ways. First, “it’s more efficient and cost-effective to move information than it is to move people,” Emerson said. This means that it doesn’t always make sense to have doctors drive for three hours to a clinic because that’s three hours they’re getting paid without seeing patients. Additionally, telemedicine reaches patients who wouldn’t have otherwise received medical attention. For instance, it can help slow or stop chronic diseases through remote monitoring and regular videoconferences
with nurses or doctors, allowing patients to receive more and better care without leaving their local communities. Left untreated, patients could end up hospitalized, which runs up costs. Telehealth enables equity of care, bringing in more patients, particularly those in underserved populations, such as people with disabilities or mental health problems and those who live in rural areas. More patients can mean more revenue, something even government-run medical facilities care about, Emerson said. To see how government agencies can use telehealth in real-world situations, consider the following scenarios: kk Telehealth can help federal, state and local organizations prepare for coordinated and appropriate responses to potential disease outbreaks. Then, when they occur, telehealth technology can bring in experts from the Centers for Disease Control and Prevention or elsewhere. For example, if a medical facility in Maine has never dealt with smallpox and someone in another location has, “we can instantly beam those people in to assess and provide care in urgent emergent situations,” Emerson said. kk Telehealth also has a place in natural disasters. Again, there’s a planning phase – how to use telemedicine to reach hard-hit regions and provide clinical services and support – and a coordination and execution phase. But natural disasters have a third phase: dealing with post-traumatic stress. “Everybody moves in when these things happen, but then after the incidence occurs, people move away,” Emerson said. “How do we provide the support to these areas that have been struck by these natural disasters and provide things such as counseling? How we can provide better coordination and support? How we can still provide clinical care after it happens?”
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CASE STUDY: TELEPSYCHIATRY IN SOUTH CAROLINA Six years ago, a shortage of mental health resources in South Carolina meant patients in emergency departments had to wait two to five days for proper evaluations. On any given day, 85 people were in an emergency room waiting for a psychiatric assessment. Something needed to be done. “Something” turned out to be a telepsychiatry consultation program that puts video equipment in psychiatrists’ offices and ERs, connecting physicians with hospitals in rural areas that lacked mental health personnel. With help from a Duke Endowment grant, the department established the program in 2009 using Polycom technology. Since then, more than 27,000 patients have been assessed through the program, which has saved patients $35 million in health care costs and cut the wait time for ER evaluations to a day or day and a half, with many patients being seen within hours. The program is in 21 of the state’s 60 hospitals, and a parallel community-based program has put equipment in 17 mental health centers and 50 mental health clinics. The hospital program treats an average of 450 patients a month, while the community one handles video consultations for twice as many.
Besides helping people get better faster, the program is producing other results, including: kk Cost savings of more than $3,000 per consultation; kk 34 percent of patients getting recommended for same-day discharge; kk A 50 percent reduction in the length of ER stays, which can cost $500 to $1,700 a day; kk A 53 percent reduction in overall length of hospital stays; and kk Fewer patients in rural facilities having to be transported – at a cost of at least $1,200 – to moreequipped hospitals. Personalized medical care, not just for mental health services, is the future of health care. Video technology and the evolution and increasing use of biosensors can provide a continuous stream of information to doctors about blood pressure, sugar levels and heart rates, for instance. Moreover, the use of portable devices and wearables will be essential to increasing response in ambulances and emergency vehicles. By using innovative video technology, government will be able to improve service to the community by meeting residents where they are, particularly in rural communities.
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CHALLENGES TO TELEHEALTH & POLYCOM’S GRANT ASSISTANCE PROGRAM Besides payment issues, agencies face many upfront costs in establishing telehealth programs, including technology investments, personnel training and information technology security to make sure the sensitive medical data and the devices used to transmit it are safe from cyberattack. Through its free Grant Assistance Program, Polycom works with health care organizations to ease the burden of both establishing and paying for a telehealth program. “We can provide state, private organizations and nonprofit organizations with the information and support needed to identify and obtain the funding necessary to implement, sustain and grow a telehealth program” Emerson said. Through the process of research, writing proposals and submitting grant
applications, Polycom can assist and support organizations, from the business development phase all the way through post-award processes. “Technology’s only one element to consider” he said. “It’s the regulatory, the policy, the strategy, the business case, the organizational alignment with telehealth — it’s all of these other things. And, in most cases, those questions are addressed in the grant application.” Polycom tracks funding from 26 federal grant-making agencies, such as the Agriculture Department, plus state and foundation funding sources. The company also offers a team of grant and industry experts, grant consulting services, free webinars on grant resources and new funding announcements, access to grant writers and tips and tools for managing and reporting on grants.
TELEHEALTH TIPS Ron Emerson, Global Director of Health Care at Polycom, has traveled to 46 countries in six years studying hospital systems. Here, he shares the telehealth tips and tricks he’s learned from those experiences.
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Successful programs align telehealth with the organization’s overall strategic goals.
Let the application drive the technology.
Consider the business case.
“I think that’s very important. If not, you just have a few clinicians who like it and think it’s cool, and then if those clinicians move away, the program collapses.”
“Put the right technology in place that’s going to meet the need. Don’t get the technology and then figure out how you’re going to use it.”
“It’s one thing to say, ‘We can do it and we have the technology that can do it,’ but make sure that the policy and regulatory environment that you’re working in really shows the true benefit from a financial perspective.”
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THE VALUE OF VIDEO CONFERENCING & HOW POLYCOM CAN HELP Technology goes hand in hand with telehealth. It can be used enterprisewide, on efforts such as project development, coordination, increasing efficiencies across state and local organizations, or for everyday uses. “What’s just as important, though, is that you can use the exact same platform. And you can use that for other applications, across a variety of settings, even from a clinical perspective,” Emerson said. For instance, the platform can be used to reach patients in their homes on any device. They can receive a link via email or text message and click it to connect to a secure, Health Insurance Portability and Accountability Act-compliant videoconference with medical professionals who are also using their devices of choice. Polycom, a leader in video conferencing and telepresence, can provide enterprise telemedicine units that integrate with medical devices and EHRs or just simply connect someone who’s been discharged from the hospital with follow-up medical care.
What’s more, Polycom has partnered with Microsoft to increase the reach of video collaboration in Office 365 and Skype for Business. It also offers its own platform, Polycom RealPresence Clariti, which lets users collaborate with anyone, anywhere and on any device. It can handle video streaming, real-time video, video archiving and video resource management. “We can help develop the high-end solutions that really solve pure telemedicine business challenges, such as listening to heart and lung sounds from a distance, looking at a skin lesion, using a rhinoscope to look in a nose, etc.,” Emerson said. “And then the other piece of that is providing software-based solutions so that government officials or clinicians can use it on their mobile device and connect to patients easily, regardless of what device they’re on.”
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CONCLUSION The health care landscape is changing, thanks to video conferencing, telehealth and patient-focused medicine. Technologies that let doctors examine patients via videoconference are often just as effective as in-person assessments. What’s more, telehealth offers benefits such as providing care to rural populations that otherwise wouldn’t get it, expediting emergency triage and facilitating disaster response efforts. Telehealth’s effectiveness is catching on, with Medicare officials and members of Congress looking to make it easier to use. Medical professionals are seeing cost savings and even increasing revenues with the implementation of telemedicine programs. Industry partners, such as Polycom, are critical to making the telehealth experience as lifelike as possible, connecting providers and patients securely and reliably to cultivate a healthier America.
ABOUT POLYCOM
ABOUT GOVLOOP
Polycom helps organizations unleash the power of human collaboration. Polycom works with healthcare customers throughout the world to deliver better collaboration within organizations and externally to patients, payers and the community. Our voice and video collaboration solutions are supporting a number of applications, including:
GovLoop’s mission is to “connect government to improve government.” We aim to inspire public-sector professionals by serving as the knowledge network for government. GovLoop connects more than 250,000 members, fostering cross-government collaboration, solving common problems and advancing government careers. GovLoop is headquartered in Washington, D.C., with a team of dedicated professionals who share a commitment to connect and improve government.
kk Telehealth and telemedicine kk Care Coordination
For more information about this report, please reach out to info@govloop.com.
kk Patient Centered Medical Home kk Reducing hospital readmissions kk Medical and Patient Education kk Hospital Administration Polycom and its global partner ecosystem provide flexible collaboration solutions for any environment that deliver the best user experience, the broadest multi-vendor interoperability and unmatched investment protection. Visit www.polycom.com/ healthcare or connect with us on Twitter, Facebook, and LinkedIn to learn more.
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