Past the Tipping Point

Last Thursday I promised to discuss our takeaways from the ATA conference individually in more detail, starting with

#1 We’re past the tipping point.

I won’t belabor the point of the overall importance of this takeaway, as you can read about it here.  However, I will re-quote ATA CEO Jonathan Linkous because his numbers make a good launching point: “Today, 20 million Americans get some part of their healthcare remotely, and that number will grow as telemedicine expands its reach.”  And the ATA President, Edward Brown, believes that mHealth/Telemedicine will grow by 50% every year.

According to a study by IHS Technology and published in January, the almost 350,000 telehealth patients in 2013 will swell to 7,000,000 by 2018.  Their report claims we haven’t yet hit the tipping point…but I think we may be discussing different tipping points.  350,000, while not tremendous, is, actually, quite tremendous.  It’s a lot more than, say, 500 patients.  And the $441 million they claim was 2013’s revenues (projected to be $4.5 billion by 2018), is not insignificant when taking into account the many obstacles that telehealth has faced.  (In fact, Brown declared the remote patient monitoring was actually already a $1.2 billion market globally–more than twice the IHS estimate!)

There is no escaping the many factors that influence the current numbers and their future trends:  Rising health costs, an aging population, a shortage of qualified medical personnel including physicians of all stripes, a push from organizations from the VA to serve all its members, and the push from implementing the Affordable Care Act (Obamacare) to cover and treat more patients at lower cost.  Lastly, within the last decade, technology finally caught up to the requirements, and within the last several years, due to the deep societal penetration of the smartphone and the tablet, resistance to trying these technologies has reduced.

Here is where I think the real tipping point lay: doctors and patients giving remote care a chance due to how comfortable they are with their devices.  One thing this implies for the future of telehealth is:  Can we improve the doctor and patient experiences individually…not just the doctor/patient experience together?  Are the interfaces and uses of the applications/devices/data such that the doctor or the patient finds the telehealth solution is making their lives easier?  Or, due to poor UI/UX design, is the solution actually making life more difficult?  With a few exceptions, usually technical and referring to things like bandwidth, the question moves from “Is there a solution that can do X?” to “Which one works most consistently and is easy to use?”  We know the technology exists to do nearly anything we think could be useful in telehealth.  The doctors and hospital administrators know this as well.  What they also know is that the experience of using that technology can–and should–be better.

While those improved interfaces are stewing away in development, are the solutions providers taking time to educate the doctors, nurses, MTs, etc., on using the solutions more effectively?  It’s now very important to make sure the users in the field aren’t just getting the solutions up and running, but that they understand how to adjust their workflows–or make the solution adjust–so that the patients are getting the best outcomes.

Lastly, as doctors, clinicians, administrators, et al. have begun to actively look for and adopt these technologies, they have been able to stop focusing on championing technology to their IT department or hospital boards and start looking at a more pragmatic question: “Who’s paying for the remote health services?”

That’s a fine question, which, if you read Thursday’s post, you know we think shouldn’t be a showstopper.  However, it does mean that we solution providers need to educate ourselves as well as our clients as to the shifting sands of reimbursement regulation.  Each state has different requirements and insurance companies haven’t quite come to grips with it.  We know the dust will settle within the next few years.  It’s almost a certainty that insurance will embrace coverage once it becomes apparent that covering, say, 80% of a video call consultation is cheaper than 80% of an in-office visit.  That day isn’t today, but it’s coming.

We shouldn’t take our doctors and surgeons and ambulance service personnel away from the business of saving lives and curing ills.  (I know I don’t.) So, until that day arrives when the reimbursement question is finally sorted out, we providers should do our best to help the healthcare professionals navigate these waters.