Recently, Credit Suisse https://credit-suisse.com experts attended a panel on telehealth adoption by hospitals/health systems. Panelists from Jefferson Health https://www.jeffersonhealth.org, Stanford Children’s Hospital https://www.stanfordchildrens.org, and St John’s Health https://healthcare.ascension.org took part in the discussion.
Views were presented on vendors and partnerships. Jefferson Health switched to Teladoc Health from American Well as their telehealth vendor in 2017. In response to a question regarding the switch of vendors, the Jefferson representative noted that pricing didn’t play a role in switching telehealth vendors.
Jefferson Health’s telehealth program powered by Teladoc’s SaaS-based platform can be integrated seamlessly into the health system’s EHR care delivery model and into doctors’ traditional workflows.
Jefferson Health recently saw that telehealth visits were hitting the 100K mark. These visits include on-demand visits, scheduled visits, and consultations. The on-demand telehealth program called “JeffConnect” offers 24/7 services to anyone in an area where Jefferson is licensed, usually with an ER physician. The scheduled telehealth visits are with primary care or specialist physicians.
When using “JeffConnect”, an individual with no insurance coverage pays $49 per visit, however, an individual with health insurance pays either a portion of the cost, or none of the cost. For scheduled telehealth visits, the health system has seen much lower cancellation rates as compared to in-person visits.
The health system also does ER tele-triage, where a provider in a remote location is able to triage to the health system sites. This approach saves costs as providers can triage into multiple sites at one time. This has also made it possible for patients to become familiar with the concept of having a doctor on the screen instead of in-person.
This program has decreased door-to-provider time for the health system, without impacting patient satisfaction. As for financial implications, the health system allocated $5 million budget to put the infrastructure for the telehealth program in place for the first couple of years.
Stanford Children’s Hospital relies on Cisco extended care telehealth platform integrated with Epic and reports that in 2018, the hospital did 3,500 telehealth visits with the uptake in specialty care coming in much better that the uptake in primary care.
For 2019, the hospital expects 8-9K telehealth visits and the strategy in 2020 is for the hospital to focus on exploring virtual urgent care programs and home monitoring. Two key areas where the company currently has home monitoring are type 1 diabetes and single ventricle patient programs.
Next year, the company is planning to expand into a virtual OB program for low risk patients for their prenatal care. Stanford Children’s Hospital reports that the key obstacle is trying to figure out how to tailor the support for the telehealth program both for patients and providers.
St John’s Health’s hospital uses MDLive’s white-labeled technology. The hospital’s representative noted that they picked MDLive since the telehealth vendor was able to match the hospital’s requirement for providing a “curated high end experience”.
St. Johns differs in that providers are only licensed to provide care in Wyoming. However, the telehealth vendor for the hospital MDLive, has providers licensed in multiple states. All of Jefferson Health’s on-demand providers are at least licensed in three states to include New Jersey, Delaware, and Pennsylvania. This provides challenges for the hospital.
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