Executive’s Thoughts on Virtual Health

Credit Suisse https://www.credit-suisse.com as part of their Healthcare Disruptive Technologies and Innovations Series, hosted Rakesh Mehta, Director, Virtual Health at Memorial Hermann Health System https://www.memorialhermann.org at a virtual meeting with a small group of investors.

Memorial Hermann employs 28 thousand people, owns and operates 14 hospitals and has formed joint ventures with three other hospital facilities. Memorial is one of the largest not-for-profit health systems in Southeast Texas and has an award-winning and nationally acclaimed ACO.

The health system uses a multi-vendor telehealth approach by using Zipnosis on the front end to provide 24-7 virtual urgent care and InTouch Health for high-end use cases for intensive care or emergency department situations such as for tele-neurology or tele-stroke where timing is critical.

Memorial also uses a native, integrated platform from Cerner for virtual office visits, which has worked very well in the current pandemic environment. This has resulted since the system had already been integrated with Memorial’s EMR. Mr. Mehta indicates that at some point, Memorial wants to move to Cerner’s integrated telehealth offering powered by Amwell. Beyond Zipnosis, Cerner, and InTouch, Memorial is looking at different platforms right now but nothing has been decided at this point as things are moving too fast with COVID-19.

Mr. Mehta discussed how virtual urgent care powered by Zipnosis visits have spiked during COVID-19 with 15x pre-COVID levels coming in at less than 10k per week. However, since the peak, Memorial has seen these numbers come down.

Virtual office visits are powered by Cerner where Memorial uses employed physicians as well as affiliated physicians within their ACO where a different platform is used. Memorial conducted around 50k visits in April between both physician groups.

Even as peak numbers have come down, Mr. Mehta believes that the forced adoption of virtual care has been achieved but he wants to see it continue both for the provider and the patient. Going forward, he is bullish that the correct regulations will stay relaxed. If that happens, health systems and providers will be able to better further their use of virtual care.

Mr. Mehta indicated that historically, Memorial has had a great uptake in using telemedicine to provide behavioral health. On the in-patient side, Memorial operates by using a hub and spoke model where a patient having mental health issues can visit with a provider from Memorial’s Behavioral Services department. To conduct these in-patient tele-behavioral visits, Memorial uses a HIPAA-compliant Zoom platform as well as the integrated Cerner-based platform.

As he further discussed, digital technologies have the highest switching costs. He cited EMRs as being one of the most strategic investments a health system can make as well as having the longest lead times. In addition to having a high capital investment, EMRs also require physician buy-in as well as extensive training

Down the line, revenue cycle management systems and population health platforms have high switching costs as well. However, relative to other systems, telehealth doesn’t result in a substantial amount in terms of switching costs.

He notes, since physicians have to manage multiple solutions to do their daily tasks, switching is not just a financial decision but also requires buy-in and adoption by physicians. He views the most important determinants in making decisions concerns switching costs, actual cost of acquiring a new system along with monthly costs, and the degree of comradery and partnership with the vendor.

COVID-19 has put the healthcare system in the limelight to find virtual care solutions. Mr. Mehta notes that this is the time to quickly come together and remove points of friction for both patients and physicians.

For more information and to provide feedback, email Jailendra Singh at jailendra.singh@credit-suisse.com or call 212-325-8121.

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