The Top Reasons behind the Low Adoption of Telehealth Services
A new topic of conversation has been building up over the cost covering an aspect of Medicare not being sufficient enough, which is a matter of concern for some healthcare provider networks.
On paper, telehealth services are the perfect answer to save costs, ensuring better access to healthcare for all. However, it seems things aren’t as easy with more patients shying away from using it, and instead, opting to go for traditional methods.
New findings by CMS reveal the alarmingly low adoption rate of Telehealth services which can provide value-based service without increasing the cost. It turns out that only a quarter of one percent of Medicare beneficiaries took help of Telehealth services between 2014 and 2016 even when the adoption rates have been increasing.
That makes it around 90,000 Medicare beneficiaries who made use of 275,199 Telehealth services- which only forms a major 0.25% of the total 35 million patients under Medicare.
It is true that CMS provides reimbursements for rural care providers over issues such as opioid treatment and home health services. But what does it translate to for the overall healthcare community and the patients?
The Challenges of Telehealth Services
Telehealth is a major contributor to value-based care and will be a useful tool for the efficient delivery of care for years to come. We have to keep this in mind and account for the challenges that come with any technology-based treatment such as Telehealth.
The first issue is the technology used in medicine. We have advanced by leaps and bounds in technology, but still, our healthcare system hasn’t been able to harness it accurately and efficiently. One of the main reasons is the gap between healthcare professionals and the manufacturer of the technology. We have to agree that Telehealth comes with limited utilities and we are dealing with high levels of physician distrust and patient alienation which restricts the growth of Telehealth services.
The second issue is the validation of the proper utility of the Telehealth system. It is not a hidden fact that almost all innovations are driven by the interests of angel investors, venture capital, private equity, entrepreneurs or a combination of all. This means most of them are looking for quick money and return on their investment. I have no issues with this, but the very nature of the business model makes the end products or deliverables vulnerable to premature rollout and bias.
The third issue deals with the nature of services delivered or utilities associated with any innovation, in this case, the Telehealth system. Currently, Medicare allows Telehealth services for opioid rehabilitation, psychiatry and rural areas. In fact, psychiatry is the most common field for adopting Telehealth services and 85.4% of people using it had a mental health diagnosis. Their use is valid as current systems cannot be used or are validated only for the specific cases.
Fourth, the innovations of the Telehealth system have been marketed to businesses and consumers as a means to replace direct onsite clinical visits. It not only fuels a misconception but can have significantly dangerous outcomes for both physicians and patients. Telehealth services can never be a complete replacement to clinical visits which are required in many cases.
Fifth, the current system with its value-based reimbursement approach encourages managed care organizations to keep their patients at home reducing the number of clinical or hospital visits. It makes perfect sense to maximize the benefits of public health and reduce cost by cutting down the number of hospital or clinic visits. But there is a very thin line between keeping patients at home by exclusively delivering virtual care and restricting patients at home because their medical problem can be managed over a Telehealth system.
Sixth, the application of the Telehealth system will set new limits on the standard of care making the resources available to everyone. However, the availability of the resources will be limited by the nature of the technology of a specific Telehealth system.
We Need to Take the Right Steps
High-level governmental control and oversight are required to ensure the quality of care and patient safety by healthcare organizations. It is also very crucial that every virtual care system is properly validated by the experts of its domains which in this case are the physicians. There should be enough awareness, knowledge, and training around the use of technology so that it can be implemented for appropriate purposes leading to better clinical judgment and maintenance of standards of medical care.
The balance between healthcare and power has to be established centered on the doctor-patient relationship. Only then we can build the trust around Telehealth services and implement it with full disclosure of its capabilities and privacy issues.
Patients should be entitled to their own health records while independent physicians need the resources to expand their scope of care too hard to reach areas with full compliance to value-based reimbursement model. We need to rise above the incentives to keep patients at their home for financial reason versus attending to them in clinics for financial reasons. Telemedicine follows the concept of personalized delivery of care model and any deviation from the personalized approach will lead to its failure.
We cannot make the mistake of selling virtual healthcare platforms without establishing the prerequisites first. The factors for an effective Telehealth model include strategy, technology, personal support, and a clear and transparent delivery model. We need to utilize the resources in a way that it maximizes efficiency and quality of care and doesn’t become another vehicle for financial profitability.
We can only deliver healthcare without borders with the application of the right strategy; otherwise, we end up narrowing the borders of healthcare.
