Advocates sell remote care at mHealth + Telehealth World

BOSTON -- The flip side of patient demand for telehealth and remote services, perhaps, is getting hospitals and providers to buy in to them.

That message was a theme of the mHealth + Telehealth World 2014 conference. One major source of trepidation that healthcare system managers feel is cost, and particularly return on investment (ROI), noted Peter Kung, director of strategic systems for the UCLA Health System.

Kung's group categorizes ROI in one-year to three-year horizons, and gauges innovation on whether the ROI is large -- at 20% or more -- or minimal, which is between 2% and 20%.

"By that matrix, UCLA innovation technology must also be reliable, have a convenient user interface and be of clinical quality," Kung said on a panel on provider buy-in. "If it decreases patient care and access, it's off the table."

UCLA innovation technology must also be reliable, have a convenient user interface and be of clinical quality. If it decreases patient care and access, it's off the table.

Another panelist, Kristi Henderson, chief advanced practice officer and director of telehealth at University of Mississippi Medical Center, said the main driver of the healthcare system's adoption of telehealth technology was the need to care for rural patients more efficiently, rather than simply visiting them in mobile vans. Now, the medical center is finding it more effective to treat chronic diseases such as diabetes by monitoring patients at home.

"We're saving mileage and offering better access," Henderson said.

Henderson noted that while some physicians might think that payments could decrease with a reduction in visits, "The no-show rate just got cut in half."

At New Hampshire's Dartmouth-Hitchcock Medical Center -- the only trauma center and teaching hospital in northern New England -- doctors bought in by realizing they could take care of patients in the 60,000-square-mile rural region more easily with video virtual visits, said panelist Sarah Pletcher, M.D., medical director of Dartmouth-Hitchcock's Center for Telehealth.

"Telemedicine takes away a lot of barriers," Pletcher said.

Kung urged CIOs and telehealth advocates to find "champions" within their organizations who can sell new devices and methodologies within their departments.

Another strategy Kung said has worked at UCLA is risk-sharing. The hospital and contractors split the costs of rolling out new systems and also share revenues.

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