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To bring in telemedicine, do homework and meet the patients – and health system CEOs – where they are

As fun as FaceTime or other video calls can be, many people may choose to decline an incoming face-to-face chat for the simple reason of, well, not wanting to show their face. Understandably, when people are sick and are choosing to engage with their doctor virtually, they may not leap at the choice of a video visit.

“When we talk about telemedicine, a lot of people immediately think video. But when you look at modes preferred, most are not even willing to use video. In fact, half would choose a modality that specifically does not include it at all,” Dr. Kevin Smith, chief clinical officer at Zipnosis, said during a presentation at the American Telemedicine Association conference in Orlando.

And they aren’t eschewing the technology for complicated reasons, either, Smith said.

“In our company, we’ve done lots of testing with groups and done lots of polling, and many testers are mainly opting out of video for things like ‘what I’m wearing,’ or ‘what my hair looks like.’ Those are the top reasons.”

But providers and health systems need not put the brakes on bringing telemedicine into their practice for fear of alienating their patients, Smith said. Most patients are more than happy to use virtual visits, and, just like their aversion to the in-your-face approach of video, most even prefer it over a real human doctor.

“In our studies, we saw 70 percent of patients who would use telehealth over human contact,” Smith said. “That can be a bit sobering for physicians, but the fact is they are not nearly as loyal to our in-person relationship as we believe them to be.”

But it’s not personal. Cost savings and convenience are the main reason, even with older patients, whom many innovators may write off as tech-phobic, but are in fact the largest users of telehealth because, as Smith said, they are the people using the most healthcare services.

So when providers want to bring in telemedicine, Smith advised, it’s important for them to do their homework and make sure they are meeting patients with the technology they actually want to use. In Smith’s own research, he found patients vastly prefer email, phone calls and e-visits – a mix of online check-ins and patient-provided data and follow-up calls, emails or texts. Accordingly, satisfaction levels with the telemedicine modalities are on par with the patients’ initially stated preferences.

Once providers figure out what their patients want, then it’s onto how exactly how to intelligently bring telemedicine into their practice. Alex White, a consultant at KPMG, explained how telemedicine could be used to grow revenue and increase efficiency in ways that simply hiring more doctors can’t.
“We have to put telemedicine in broader context of growth strategy. When we are talking about delivering on a supply side of physicians, we can see how health systems may or many not be able to act on this demand,” White said in a presentation. “And it is clearly and definitely proven that we have to find out what consumers want before bringing in technology.”

To illustrate his point, White describe two hypothetical health systems. One hires more doctors to grapple with more patients than they could previously handle. The other brings in telemedicine to extend the reach of their existing physicians.

“You have one hospital CEO who says the way out of a problem is to grow, which will lead to economies of scale. Then you have another who wants to drive patient loyalty and physician productivity,” White said. “But the first one will most likely get is more patients, so the problem doesn’t change and you now have more costs associated with those extra physicians and the promotion of their extra services. Not only are you just as inefficient as ever, you are losing more money.”

Of course, there may be situations when health systems do have to hire more doctors, but at the same time, they should start thinking about operating models that could drive productivity, White said. That means taking polls, like Smith said, and figuring out what patients want and which modalities deliver the best engagement and outcomes.

“I don’t know why, but very few health systems are using CRM and they really should be. You need to be able to strip out noise and figure out ways to reframe telemedicine access programs in ways the CFO, CEO and COO will understand,” he said. “That means explain how you will grow, emphasize the lifetime value of retaining a patient, and not canonizing the in-patient visits.”

RapidSOS gets $14M to continue bringing 911 into the 21st century

RapidSOS, a 4-year-old startup with roots at Harvard and MIT, has raised $14 million to, at long last, bring 9-1-1 and other first responder networks into the smartphone age. The roster of backers for the round includes three former FCC Chairmen and the investment arms of Motorola and Triple A, in addition to a number of other investors.

Highland Capital Partners led the round with participation from A3 Ventures, The Westly Group, Two Sigma Ventures, Motorola Solutions Venture Capital and Responder Ventures. Former FCC Chairs Tom Wheeler, Julius Genachowski, and Dennis Patrick also contributed along with other undisclosed individuals.

“For the last 50 years – we’ve relied on a voice-only connection when our lives were on the line – whether from us or through a home security, medical alert, or roadside assistance call center,” Dan Nova, a Partner at Highland Capital Partners and RapidSOS board member, said in a statement. “RapidSOS’ technology eliminates the need for clunky third-party call centers – providing a transformative platform for safety, security, and wellness.”

RapidSOS’s technology was originally developed by CEO Michael Martin, CTO Nick Horelik and a team of engineers out of MIT and Harvard. We reported on RapidSOS back in 2014 when it won the audience choice award at the MIT$100K entrepreneurship competition.

The company has spent the last four years partnering with local, state, and national goverments, as well as technology companies, to create a pathway to transmit rich data directly from mobile devices, wearables, and smart cars and homes to 9-1-1 dispatch centers. The result is a major improvement on the status quo, where responders have to rely on just a voice call for information and often can’t pinpoint precisely the location of an emergency. RapidSOS offers an app called Haven which organizations can deploy and whitelabel, as well as an API.

“I spent much of my career as Chairman of the FCC working to strengthen public safety and make improvements to our nation’s 911 system,” Wheeler said in a statement. “I am thrilled to have the opportunity to work directly with RapidSOS as they deploy their emergency platform to enhance the data available to 911 and first responder systems nationwide.”

Wheeler, the most recent FCC chairman, has been a staunch advocate of NextGen 911, an FCC initiative to move 911 from just phone calls to include texting and rich data, but that project has stalled over the last four years. In 2016, shortly before leaving office, Wheeler blamed a lack of Congressional support for the delay.

Report: All but two states have some Medicaid telemedicine reimbursement

The Center for Connected Health Policy has released the fifth edition of its State Telehealth Laws and Reimbursement Policies Report. CCHP uncovered many notable findings in the new report. Perhaps chief among those: 48 states and Washington, D.C., provide reimbursement for some form of live video in Medicaid fee-for-service.

Specifically, 13 states reimburse for store-and-forward delivered services in Medicaid; states that only provide reimbursement for teleradiology were not counted in this number. Twenty-two states reimburse in Medicaid for remote patient monitoring.

The report also found that 31 states provide a transmission and/or facility fee. Six states have geographic/rural restrictions. And 23 states limit Medicaid reimbursement to a specific list of facilities.

“While many states are beginning to expand telehealth reimbursement, others continue to restrict and place limitations on telehealth delivered services,” CCHP said in the report. “Although each state’s laws, regulations and Medicaid program policies differ significantly, certain trends are evident when examining the various policies.”

When it comes to private payer reimbursement, 35 jurisdictions have laws that govern reimbursement of telehealth, the report found. This number has remained constant since CCHP’s August 2016 update, although some states have made modifications to their private payer law. Some laws require reimbursement be equal to in-person coverage; however, not all laws mandate reimbursement.
Looking to the future, CCHP noted that 44 states have already introduced some 200 pieces of telehealth-related legislation addressing reimbursement for both private payers and government agencies.

“Other noteworthy trends include the addition of the home as an eligible originating site in some states, and the inclusion of teledentistry as a speciality qualifying for Medicaid reimbursement and/or required to be reimbursed by private insurers,” CCHP said.

AiDoc raises $7M for AI-powered medical image analysis software

While medical imaging technologies have gotten more sophisticated and commonplace over the years, the number of available radiologists or clinicians to read things like CT scans or MRIs haven’t increased accordingly. But tools that leverage machine learning have gotten smarter, and engineers believe they could play a vital role in alleviating the high demands on human medical image interpreters.

Keep reading>>

Digital health news briefs for 4/26/2017

DarioHealth launches in the UK. Israel-based DarioHealth, makers of a smartphone-connected glucometer, announced the launch of a direct-to-consumer channel in the United Kingdom. It is already available D2C in the US and Australia, but was previously available in the UK only through pharmacies and diabetes educators.

Keep reading>>

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connie dello buono

Health educator, author and enterpreneur or ; cell 408-854-1883 Helping families in the bay area by providing compassionate and live-in caregivers for homebound bay area seniors. Blogs at Currently writing a self help and self cure ebook to help transform others in their journey to wellness, Healing within, transform inside and out. This is a compilation of topics Connie answered at and posts in this site.

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