A sweeping new national telehealth survey by URAC and Telemedicine Magazine provides an interesting snapshot regarding the status of telehealth realities and aspirations among a host of key groups.
More than 70 percent of all respondents use telehealth now, and of those who don’t use telehealth, 44 percent plan to within the next five years. Around nine percent of hospitals/health systems say they do not use telehealth, but of those, 43 percent plan to within the next year, 29 percent within two to five years, according to the survey.
The full results of the survey will be presented in a session, Top Challenges and Trends in Telehealth: What’s Working, What’s Not, at the Telemed Leadership Forum 2018: ROI of Telehealth, in Washington, DC, March 27-29.
The optimism is tempered somewhat by an array of challenges facing current and prospective adopters.
For example, on a one to ten scale, with ten representing the greatest degree of difficulty, roughly half of hospital/health systems reported Medicare of Medicaid reimbursement rates was one of their biggest hurdles, giving it a nine or ten. Another 20 percent gave it a seven or eight.
Physician practice/network respondents also reported similar challenges with Medicare or Medicaid reimbursement rates. More than 25 percent labeled it a ten, with another 30 percent giving it a seven or eight.
The situation wasn’t much different when it came to private payer reimbursement, the survey revealed. More than half in the hospital/health systems category gave it an eight, nine, or ten. Nearly half in the physician practice/network gave it the same score.
Challenges weren’t limited to dollars and cents. Nearly ten percent of hospital/health system respondents cited physician acceptance/buy-in as one of their greatest challenges, giving it a ten score. Some 30 percent rated it either a five or seven, also suggesting a struggle to educate and engage the physician sector.
Looking at physician practice/network, nearly 50 percent expressed some trouble engaging physicians, scoring it a five or six on the one to ten scale.
Just over 40 percent of hospital/health system respondents said they’d launch telemedicine initiatives within the next year. Nearly 30 percent reported they’d move in that direction in the next two to five years.
Pharmacies were one of the groups moving most slowly toward telemedicine. About 15 percent of respondents said they’d engage in it within the next year. Nearly 20 percent said they planned to do it in the next two to five years.
Increasing access to care was the top adoption driver for the hospital/health system and physician practice/network categories, with 100 percent of respondents citing it.
Some 80 percent of the hospital/health system group selected “better coordination of care,” listing overall connection with physicians as their third highest motivation for adoption.
Not surprisingly, personnel in the physician practice/network category looked at the equation a bit differently. Approximately 75 percent cited improved patient engagement as a secondary driver, with the prospect of providing better coordination of care rounding out the top three motivating factors, at approximately 55 percent of respondents.
The majority of pharmacies responding to the study, or about 65 percent, hope to increase access to care with new telehealth programs.
“We see the healthcare industry from a unique vantage: everything from small physician practices, to pharmacies to large health systems and insurers, and telehealth impacts each one of those groups differently,” said Che Parker, Vice President, Sales and Marketing, URAC. “Our goal was to probe the use and uptake of telehealth not only from a practical sense, but also from the perspective of an independent accreditor. The results are encouraging. They also underscore the need for national standards, which URAC now offers, regarding the practice of telemedicine.”
Relative success rates for those who’ve already launched telehealth programs varied. The physician practice/network category reported the highest satisfaction level, at nearly 21percent, followed by hospital/health system at just over 17 percent, and the pharmacy category checking in with a nearly 15percent rate.
More than half of hospital/health system respondents gave themselves a “somewhat successful” report card. Just under half of physician practice/network survey respondents echoed that assessment. Just over 40% of pharmacy category participants said the same of their own work thus far.
There were clear success factors for those organizations that are meeting their telehealth program goals. Overall, of organizations that said they have met or exceeded their telehealth program goals (somewhat agree or strongly agree), nearly 65 percent said they have strong executive leadership support; 79 percent said they have physician leadership to drive the growth of the telehealth program; 84 percent have hands-on physician training; 80 percent have outcomes tracking over time; 64 percent have integration with EMR/HER.
The survey found a commonality regarding the most common types of technology fueling telehealth efforts. Real-time Audio/video conferencing was cited as the most used technology among the physician practice/network, hospital/health system, and pharmacy categories, followed by remote patient monitoring.
When asked to identify and prioritize telehealth services they currently provide, the hospital/health system category ranked acute care, followed closely by chronic conditions, and behavioral healthcare as the most prevalent. Physician practice/network participants ranked chronic conditions first, followed closely by acute care, and behavioral healthcare. Pharmacists cited medication management as their top telehealth offering, followed by chronic conditions, and acute care.
Hospital/health system reported telestroke/teleneurology as the service they most often provided, followed by telepsychiatry, and teledermatology.
Telepsychiatry topped the list for physician practice/network category respondents, followed by telestroke/teleneurology, and telepharmacy. The latter was also ranked first in the pharmacy category, with tele ICU and oncology a distant second and third.
With regard to accreditation, nearly 90 percent saw value in the process. They believed that telehealth accreditation could help ensure that telehealth providers adhere to high standards of quality of care (77 percent), patient safety (70 percent), quality improvement practices (65 percent), professional ethical standards (59 percent), patient privacy/security (59 percent), and continuity of care (56 percent).
Responses to the online telehealth survey were collected in October and November of 2017. There were 475 respondents from across the healthcare spectrum.