Mei Wa Kwong is Policy Advisor and Project Director at the Center for Connected Health Policy in the U.S.. As healthcare grapples with how telehealth can be utilised for better patient outcomes, Kwong answers HealthManagement.org’s question: In What Ways Can Telehealth Enhance Value Based Care?
Value-based care has been the subject of much discussion in US healthcare. While the definition of what “value” means may vary from person to person, most do see value as encompassing the goals of the Triple Aim of quality care, better health outcomes and lower costs. As the health care industry grapples with how to deliver value based care, telehealth is being increasingly looked towards as a potential tool to achieve this significant goal. Telehealth is the use of technology to provide care from a distance when the patient and provider are in two different locations. The unique features of telehealth lend itself well to a variety of ways of utilisation that would help achieve these goals.
There are a variety of ways telehealth technologies can provide quality care. Though questions still persist from some sectors whether the care delivered via telehealth is “as good” as in-person care, there are definitely situations where technology can do more than an in-person interaction in the same situation. For example, in the case of a dermatological consultation, the technology allows a dermatologist to zoom in and magnify features of a condition that may not be evident to the naked eye.
Telehealth can also provide quality care by increasing access to care itself. The United States currently has a shortage of specialty providers and currently practicing specialty providers are unevenly distributed throughout the nation leaving wide swathes of the population without access to needed health services or forcing patients to travel great distances to receive it, expending time and money to do so. With telehealth, providers can reach more patients over a wider geographic area and in a timely fashion that would be more convenient to patients.
Another example of where telehealth can help improve quality care is care coordination. With different providers seeing to the disparate needs of a patient, communication and coordination may not always happen. This may result in duplicative treatments, gaps in treatment or perhaps treatment that might conflict. Utilising technology to allow different providers to work together to organise patient care and share information would not only improve care, but help enhance the patient experience as all of his or her providers work in concert.
Using technology to create efficiencies and preventing episodes from deteriorating to a more serious condition can lead to lower costs to the health system. For example, remote patient monitoring (RPM), one of the modalities that comprises telehealth, has been shown to improve patient outcomes, especially those with chronic conditions, by reducing hospitalisations. RPM can be used to continuously monitor a patient’s condition while they are at home. More serious episodes that could result in a trip to a hospital emergency room can be prevented in some cases by noticing and addressing issues before the patient’s condition deteriorates. The issue is addressed before a costly trip to a hospital is necessary, not only saving money, but preventing the patient from a more serious episode.
Better Health Outcomes
By improving care and preventing more serious episodes, patients will see better health outcomes. This is starkly illustrated in the use of telehealth in providing stroke care. In certain stroke cases, the timely administration of a clot-busting drug called tPA (Tissue plasminogen activator) can minimise the adverse effects of a stroke and in some cases avoid them altogether. However, it requires a neurologist to assess and make that decision to administer the drug and the window of opportunity to do so is very small. With the shortage of neurologists in the US, there simply aren’t enough to have one physically in every hospital and emergency room where a stroke case may be admitted. However, with the use of telehealth, those few neurologists can expand their reach and service more locations to the benefit of those stroke patients.
With the foregoing, it’s easy to see why telehealth is being sought out as a means to achieve value based care. With the coming changes of a Trump presidency, it is likely that health systems will make even greater efforts to seek out ways to achieve value based care. If they have not already, these systems should look towards telehealth to assist them with these efforts.