Starting in the New Year our company benefits will begin covering virtual visits via TeleDoc. This got me thinking about some of the change in how we receive our healthcare.
TeleHealth: What are we waiting for?
A few days ago NPR reported on a story from Lebanon County Pennsylvania where funding delays at the state level caused a domestic violence counseling center to cut back on services to the women they care for. One of those services was transportation for women in need of support and therapy. The cutback led one woman to miss multiple therapy sessions. She subsequently tried to take her own life and remains hospitalized. This is a sad and tragic event that did not have to happen.
Cut-backs are not isolated to PA, organizations across the nation that work with the traumatized and vulnerable are forced to eliminate services – leaving fragile individuals without necessary access to care. In rural Indiana eight counties don’t have any mental health providers and many other parts of the state are seriously under-served and staffed. The state is nearly 150 mental health providers short of what is necessary to care for residents.
According to the National Alliance on Mental Illness, nearly 60% of adults with a mental illness fail to get treatment each year.
So here’s the rub. This is 2015 and the majority of U.S. adults have access to mobile devices and computers. Services like Doctor on Demand are staffed and equipped to handle behavioral therapy with a trained professional in just moments and in critical moments of need. For veterans suffering from PTSD, Former Naval F-18 fighter pilot Richard Gengler founded Prevail Health. The cognitive behavioral therapy solution is fully digital, proven to be as effective as in-person therapy and is 99% cheaper. Prevail has now expanded their solutions beyond veterans.
Efficacy is not the issue either. According to an October 22 report from iHealthBeat, “A 2012 systematic literature review published in the journal Psychological Science found that videoconferencing psychotherapy has similar clinical outcomes to traditional face-to-face psychotherapy. The study also found that patient satisfaction with tele-psychology is generally high.”
So what is the barrier? Is it cost, patients, payers or the practitioners themselves? It is all of the above.
New York recently became the 22nd state to require parity in reimbursement for telehealth visits. While not 50% of states, cost should not be the barrier in a large portion of the nation.
Use of telemedicine remains low today (7% according to Rock Health’s Digital Health Adoption Report released last week), but desire to access and utilize telemedicine is at 64% according to American Well® the nations largest telehealth provider.
This is a market that was worth $100 million in 2013 and is speculated to reach $43.4 billion within five years.
Telemedicine is coming. It is cheaper, faster, often as efficacious, and can be an offset to an impending physician shortage. All aspects of the system – particularly providers faced with outcomes based reimbursement – need to not only get comfortable but also begin to view telemedicine as a strategic asset to fill gaps and to motivate terrestrial visits when necessary.
In the not too distant future, we will look at the wasted hours in scheduling appointments and sitting waiting rooms and think, “what were we doing?” Doctors will find more time to care for patients, when they can deliver care efficiently from anywhere.
The woman in Lebanon County PA didn’t have to reach a point where she felt hopeless. It wasn’t the lack of a shuttle bus to her therapy, it was a system failure and a failure to think creatively about how we simplify and equalize access to care.
Technology isn’t always the answer, but it should never be the barrier.