Lessons from Telehealth Pioneers

The three big issues in health care are usually listed as cost, quality and access.  One approach that can help ameliorate each is telemedicine, which brings a remote health care resource to the patient through use of communications technology.  Theoretically, because the interaction is usually virtual, there is less fixed cost attached to it and it saves travel time and expense for patients, especially those in remote areas.  It also allows wider and more efficient use of scarcer medical expertise, such as infrequently used specialties.  But as with any change, there have been hiccups on the path to widespread use.  A Commonwealth Fund report describes lessons from early users of one telehealth technology–remote patient monitoring.   (Commonwealth Fund Brief)   Three pilots, which later were expanded, were used in this case study–the Veterans Health Administration, Partners HealthCare and Centura Health at Home.

In each case, various biometric and other data collection devices were placed in the patient’s home and used to relay information to a care management team at the medical facility which reviewed the data and determined if and how the patient’s treatment should be adjusted.  As usual, one of the challenges was just helping staff to deal with the change; with delivering care in a different way and learning new care and work processes.  Barriers which might discourage patients from participating, whether financial, intellectual or physical, need to be removed or lowered.  New work teams need to be formed that include technology savvy staff as well as traditional care providers.  And the value of the program needs to be carefully measured, both from a quality and cost perspective.  Expectations on cost-savings should be kept realistic.  Each of these programs demonstrated improvements in measures like readmissions and patient satisfaction and appear to create overall spending reductions.