Two Very Different Reasons for Implementing Telemedicine

Why do hospitals launch technology-based telemedicine services?  To extend their geographic reach? Because doing so is the latest trend?  Because they can?  Because their competitors have similar programs?

Last week, I had the privilege of moderating a panel called “Achieving Provider Buy-In for Connected Healthcare Programs” at the Care Coordination and Technology Congress in Atlanta. We focused largely on why hospitals start telemedicine programs.

The first order of business was defining terms.  “Telemedicine” can mean:

·         Traditional use of technology for real-time clinical visits to patients in a remote location


·         Any type of health activity – such as remote patient monitoring, app-based care, etc. –  conducted using technology

Our discussion focused primarily on the first definition.

Unfortunately, a family emergency prevented one of our scheduled panelists attending.  However, we got rich insights from the other two experts.  I especially enjoyed their insights into two very different reasons their organizations implemented telemedicine programs.

Rob Marchuk, Vice President of Ancillary Services for Adventist Health on the West Coast, described how traditional telemedicine has allowed his system to address the health needs of its rural population spread throughout three states.  With about 20 hospitals and 300 rural health clinics, Adventist is California’s largest provider of rural health.  Its rural outreach fits the classic model for telemedicine:  extending the reach of specialists into areas that would otherwise go underserved.  Since the program began about four years ago, Adventist has expanded it to include other non-video modalities.  And Adventist’s telehealth program has emerged as a critical element of the system’s integrated care model.

The other panelist – Erich Fogg, PA-C, MMSc. EM-CAQ – is Director and Lead Provider at York Hospital Virtual Care Walk-In Clinic in York, Maine.  Since York is essentially part of the Greater Boston market, patient access is not an issue.  Instead, York developed the virtual care program as a cost avoidance and ER throughout management program.  

York Hospital offers three levels of immediate care: 

·         Standard ER services – at full ER prices

·         Low-intensity walk-in care – at $125 per visit

·         Virtual visits – for a $39 flat fee

Patients access the York website and describe their medical situation.  If the triage process identifies the patient as a potential candidate for the virtual visit program, they are offered the option of a video conference with a clinician using their smart phone, tablet or camera-enabled computer.  Less complex problems such as headaches, rashes, sprains, and seasonal allergies are good candidates for virtual visits.  This program has proven to be a convenient, cost-saving care option for patients who otherwise would have incurred much higher costs – and would have increased unnecessary traffic –  through more conventional care delivery channels.

The audience at the Care Coordination and Technology Congress was impressed by the effectiveness of these very different applications of telehealth care, each tailored to the health systems’ respective market needs.  As virtual care continues to proliferate, we can expect to see more and more examples of how it continues to transform healthcare delivery in creative and cost-effective ways.