Essential Checklist for Getting Started in Telemedicine
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Didn’t make it to the ATA conference this year? Get a recap of the most noteworthy insights from this year’s discussions and learn what telehealth industry leaders have to say about the future of digital health.
Last week, the American Telemedicine Association (ATA) held its annual conference in New Orleans. The ATA is the world’s largest association dedicated to telehealth. The conference brings together the best and brightest minds in the industry from medical researchers and academics, practicing telehealth clinicians, software platforms, and digital health companies.
The discussions that take place at the ATA set the tone for the future of the digital health industry. In 2019, several new trends are emerging that set the stage for a new consumer-focused paradigm in healthcare. Here are the biggest takeaways we learned at this year’s conference.
Referencing patients as “consumers” has slowly infiltrated the healthcare industry vocabulary over the last decade. 2019 feels like the tipping point where the notion of “patient experience” is being supplanted by the “consumer experience.” Consumers are increasingly taking a proactive role in their healthcare choices. Innovative companies are now meeting that consumer demand with an influx of direct-to-consumer models (more on that later) and the increasing significance of retail clinics like CVS Health.
Just think about what it means to be a patient. The definition of a patient is a person receiving or registered to receive medical treatment. The synonyms of patient are sick person, case, sufferer, or victim. Patient conjures the image of a passive person in a bed waiting for help. In this world, health plans dictate where, when, and how the average person engages with the healthcare system.
A consumer is defined as a person who purchases goods or services for personal use. A consumer takes action. And a consumer determines the best path at the right time and place for their unique life. This shift finally feels like more than industry lip service. Digital health technology is enabling consumers to take back the power of choice - the power to own their healthcare experience.
Several digital health companies experienced meteoric growth in the last 12 months. The sudden rise in the popularity of these direct-to-consumer telehealth services has created fans and detractors alike. Recently, a New York Times article profiling consumer telehealth companies put a spotlight on the booming industry.
Many more traditional medical institutions view this D2C shift as “bad medicine” compared to more traditional healthcare treatment options. However, the question must be asked…
Would digital health companies have a chance to achieve such massive growth if traditional medical options were meeting consumers’ needs?
Some of the backlash on these new models centers on the use of asynchronous medical assessments. An asynchronous medical assessment is a recent advancement to traditional telemedicine. Simply defined, asynchronous medical assessments are medical assessments where the patient and clinician are not communicating at the same time, therefore “asynchronous” information is shared.
The best asynchronous assessment software uses best practice clinical protocols to drive significant clinical efficiency, enabling providers to diagnose and develop a treatment plan for patients in a matter of minutes. The software works by asking questions about a patient’s medical history and current health status. And the software is adaptive, with a decision tree behind the scenes adapting the questions based on the patient’s responses - essentially mirroring the interaction between a patient and clinician in real life.
Asynchronous telemedicine as a modality of telemedicine can certainly have bad actors online: those who prescribe with minimal patient detail or shady organizations with the sole goal of selling pharmaceuticals. But, as pointed out in an excellent panel on direct-to-consumer telemedicine, these software enabled medical assessments can often be more thorough, more detailed, and better aligned with medical best practices.
As an example, a doctor in an in-person visit may forget to ask an important question or may prescribe a medication without appreciating a contraindication to existing medication. With software-enabled dynamic medical assessments, no stone is left unturned. The software’s medical assessment adapts to the patient’s unique answers. Issues like medical contraindications are verified against machine learning databases versus the memory bank of a single clinician.
For many physicians, these adaptive medical assessments actually offer more clarity than a traditional exam. In the end, there is no right or wrong. It is not “good” in person vs “bad” telemedicine. Asynchronous telemedicine software is a tool to facilitate better access to affordable healthcare to all consumers.
Left to right: Karen Deli, Dr. Mia Finkelston, Dr. Til Jolly, Griffin Mulcahey, Tim Dall
Our own Griffin Mulcahey had the privilege of speaking on a panel discussing the Impact of Telecare on the Health Care Workforce alongside colleagues from SOC Telemed, InTouch Health, AmWell, and IHS Markit. The panel began with an in-depth overview of the pending massive physician shortage the US will face in 2020 and beyond. As Tim Dall of IHS Markit highlighted, not only will the US face a primary care physician shortage, but also a shortage in many much-needed specialist physicians such as cardiology and neurology. The future sounded a bit bleak.
The discussion then shifted to the many ways digital health tools and telemedicine can expand the reach of our best medical professionals. For example, a primary care physician can effectively treat dozens of consumers a day from the comfort of a home office, while saving the consumer from the time of waiting rooms or the cost of an urgent care visit.
Specialist networks like the network built by InTouch Health extend the impact of the best neurologists in the country to reach stroke patients nationwide - in rural hospitals or big cities and during business hours or the middle of the night. And InTouch’s atmosphere isn’t merely about helping patients. By connecting the nation’s top specialists virtually, physicians have created an academic atmosphere where specialists can share best practices, discuss complex cases, and rely on each other for feedback.
Finally, AI-driven tools are facilitating new ways to augment the care of our existing medical professionals that will help reduce the strain of our limited physician capacity. AI augmentation can bring the expertise of a cardiologist referral right alongside a primary care provider’s treatment. By using adaptive AI augmentation the best practices of urology can help give peace-of-mind to a patient fearing a cancer diagnosis in real-time, instead of waiting anxiously for four months to see a specialist.
The growth of digital health disrupters is bending the curve on consumer expectations. And the nation’s largest health insurers and health systems have taken notice and are taking action. Many health systems have been early adopters in telemedicine technology. But in this new market, simply providing video consults isn’t enough to meet consumer demand. The industry is starting to adopt better ways to engage, triage, and treat consumers without them having to become patients in a hospital bed. As risk sharing increases in hospitals, the market will see even more adoption of augmented care tools and remote patient monitoring.
The future is all about meeting patients where they are, not where the hospital is.
For the last 20 years, the concept that started out as “telemedicine” has evolved: from a specific definition as the remote diagnosis and treatment of patients by means of telecommunications technology, to the broader concept of telehealth, to now falling under the larger umbrella of “digital health.”
Digital health, as a broad category, includes any technology tool that advances consumer health. That categorization includes direct patient treatment via telemedicine while also including the health data a consumer is tracking from a wearable device, iWatch, or oura ring.
Every attendee at ATA is ultimately both an innovator and a consumer of healthcare. As consumers, we can all benefit from the healthcare ecosystem and should take the broader view of digital health technology as one part of the larger inclusive healthcare tent, not as a separate sideshow.
This transition to a more inclusive mindset is highlighting many challenges that telehealth innovators and entrepreneurs must face head-on. Policy makers are tackling challenges in how we regulate and reimburse medical services. Innovative platforms are facing the challenge of efficiently scaling telehealth delivery across the nation or internationally. And medical thought leaders are challenged with reshaping clinical education and training to foster webside manner skills for clinicians to better engage, monitor, or treat patients remotely, and to finally challenge the long-held assumptions about how a consumer should engage with the healthcare system.
These challenges are worth embracing. In the very near future, the majority of healthcare interactions will begin with some digital health engagement. The innovators and thought leaders at ATA 2019 are now taking a more holistic approach to better healthcare delivery.