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ADVANCE Perspective: Nurses

The Future of Telehealth

Published August 14, 2012 1:24 PM by Guest Blogger
By Jon Shankman, MPH, MBA, vice president of analytics/AMC Health

More and more of the world's healthcare organizations embrace remote healthcare services and technologies as an integral part of routine healthcare they provide. Studies conducted over the past 6 years support incorporating these innovations into U.S. comprehensive care management programs. Why can't U.S. healthcare organizations see what others so clearly can and how much longer can they afford not to adopt these methods?

Of the more than 2,000 telemonitoring studies, an overwhelming majority confirm the powerful savings remote healthcare services and their technologies provide: hospital readmissions down 83 percent, home nursing visits decreased 66 percent and overall costs lowered more than 30 percent. Additionally, both patients and caregivers reported higher satisfaction scores related to the increased involvement with their own care.

These findings should prove valuable enough on their own. But what is accepted in the rest of the world -- particularly in the U.K. -- is not supported in the U.S. (the US Department of Veterans Affairs notwithstanding). Simply put, the payers and providers need more proof. They're skeptical and want airtight, practically guaranteed outcomes before overhauling their business models again. Changing their minds requires efficacy studies of telehealth; studies that meet the criteria of the peer-reviewed research arena strong enough to counter all potential biases and to satisfy diehard naysayers. 

Unfortunately, a very small percentage of the studies mentioned above met these high standards and U.S. payers know it. They know you can't replicate these studies in a research lab and they realize this alone makes them impractical in real business environments. They understand how the sample size is often too small, the duration of the study too short, the controls too lax. Their hesitancy and skepticism is understandable. Remember, these are the same executives still waiting for the billions of dollars in savings current disease management methods promised them 20 years ago

That's the dilemma. Prospective telehealth buyers demand research they themselves would not spend money on even if it were beneficial in the long run. You can imagine why an efficacy study that met this criterion above would be invaluable to telehealth advocates.

Recently Geisinger Health System in Danville, PA, conducted such a study and published the results of its simple data gathering technology. In their study, the risk of 30-day readmissions was 44 percent lower for those receiving telehealth on top of care management than for the control receiving care management alone.

In the meantime, all prospective buyers of remote healthcare services and technologies solutions can rest easily enough in the ever-growing body of accumulated evidence of sufficient quality to overcome their hesitation to deploy pilots, particularly when they are hemorrhaging from high cost subpopulations -- and nothing else has worked thus far. They can also feel secure in one other aspect: remote healthcare services and technologies work because they should. It's not magic. Remote healthcare services and technologies allow care managers to detect pre-acute conditions far enough upstream that issues can be addressed before a trip to the hospital, and it goes a giant step further than traditional disease management by enabling patients to make direct connections between specific behaviors and immediate outcome. Nevertheless, it's always comforting when hard data supports what we know intuitively to be true.

posted by Guest Blogger


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