The pilot program called “LG Connections” is very successful according to Thomas E. Beeman, PhD, President and CEO for Lancaster General Health. He appeared before the House Committee on Energy and Commerce’s Subcommittee on Health, to present his ideas at the “Telehealth to Digital Medicine: How 21st Century Technology Can Benefit Patients” hearing held May 1, 2014 on Capitol Hill.
He reported that Lancaster General Health developed the pilot program several years ago. The pilot uses multidisciplinary care teams consisting of a case manager, lawyer, medical care providers, pharmacists, psychologists, and social workers to manage a group of 30 patients.
The multidisciplinary care team uses technology to enable the use of telehealth incorporating an integrated platform spanning all care settings that extends into the home and workplace. Mobile health applications also play a prominent role in providing ongoing care.
Since 2011, the health system has expanded the pilot program to over 100 LG Care Connection patients, and the results show that inpatient visits for this group decreased by 67 percent, inpatient days in the hospital decreased by 84 percent, and emergency room visits decreased by 26 percent.
Another witness, Ateev Mehrotra, MD, Policy Analyst, for Rand Corporation, and Associate Professor of Health Care Policy and Medicine at Harvard Medical School, presented several options to the Subcommittee showcasing telehealth.
For example:
- Some 200,000 people in Pittsburgh have online accounts hosted by their health system to enable them to use their computers and smart phones to look up test results and send messages to their physician
- Nurses at Wayne State in Detroit are studying whether text messages sent to patients with hypertension can help improve their blood pressure
- In Oak Brook Illinois, intensive care physicians and nurses are managing about 250 patients at eight different hospitals in the region from a single command center where they monitor vital signs, lab tests, and do other studies
- In San Francisco, physicians have set up kiosks in emergency departments and urgent care centers where patients answer questions and then based on the answers, a computer algorithm decides on the course of care
- In Rochester Minnesota, primary care physicians are using eConsults to replace specialty visits. When a patient sees a primary care physician and a specialist’s input is necessary, the primary care provider can ask the question electronically via eConsults
Dr. Mehrotra reports that although telehealth may improve access it doesn’t always provide care for the populations we expect. Telehealth has great appeal to be used in rural areas, however, it has been noted that people living in urban areas primarily in high income areas are the most likely to use telehealth.
Summing up his ideas before the Committee, he suggests that telehealth can lead to lower costs per clinical encounter, but could also drive increases in healthcare spending by increasing the number of clinical encounters overall. To reduce healthcare costs, telehealth options must replace in person visits and lead to improvements in health otherwise, increases could be incurred without adding health benefits.