Dr. Erkan Hassan

Monthly Writings

Evaluations and reviews of the latest in the field.

Development of a Tele-Driven Health Strategy

Healthcare systems seeking to improve health care quality, increase access and lower costs should be expanding not contracting telehealth.

  • Development of a sustainable telehealth solution should be designed to serve a long-term purpose.

  • The traditional episodic sick care model is not designed to meaningfully address long-term patient care needs, especially virtually.

  • Digitalization of the care model must synchronize the full continuum of patient needs throughout their health care journey.

  • One size will not fit all.

Background

  • The use of tele-health should be expanding not contracting, with a goal of improved broader care delivery at a lower cost.

  • Development of such a strategy is hindered by the following “Known Unknowns”:

    • Government regulations

    • Payment considerations

    • Patient and provider acceptance

  • Common questions regarding the use of technology to deliver patient care is the easy part.

  • What is difficult is the development and implementation of a Tele-Driven Health Strategy in order to:

    • Deliver improved care

    • Increase access to care

    • Reduce healthcare spending 

  • The ideal definition of Tele-Driven Health was recently defined by Pearl & Wayling (Harvard Business Review May-June 2022) as:

    “An integrated, pre-paid, tech-enabled system where teams of primary care and specialists work together to deliver exceptional care.”

Review

To achieve this Tele-Driven Health Strategy, the following 4 areas should be considered:

 

Reducing Unnecessary Emergency Department (ED) Trips:

  • With ED expenses being 12 times greater than an office visit, unnecessary visits account for $32 billion per year.

  • A telemedicine strategy should be developed to:

    • Remotely solve the problem up to 60% of the time.

    • Schedule follow up appointments if needed

    • Improve patient and provider communication

ED Visits Emergent vs Non-Emergent

Address Morbidity and Mortality from Chronic Diseases:

  • Chronic diseases are the leading cause of death and disability in the U.S.

  • The current approach of intermittent/episodic care (every 3-6 months) is inefficient.

  • Virtual visits should be a supplement and not a replacement to face to face visits

Precentage of patients with 3 or more chronic diseases

.Focus on Disparities in Health Care:

  • Provide services to underserved areas and populations.

  • This is not limited to rural geographic areas.

  • Urban areas with limited bus transportation or lack of reliable child care are also problem areas

  • A greater need exists for primary care providers in non-rural areas.

 Improve Specialty Care via Telemedicine:

  • Results in quicker, more effective care

  • Can solve the initial problem in approximately 40% of the cases

  • Can quicken face to face appointment scheduling

  • Fewer missed workdays by patients

 CONCLUSIONS:

Effective integration of telemedicine can:

  • Link the entire team together in a coordinated fashion

  • Provide integration of data into the electronic health record

  • Communicate across disciplines

  • Provide a profitable value based approach.

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Erkan Hassan