Healthcare is a worldwide issue, and never has it been more front and center in this country than today. People all around the US have been picking up the phone to dial their local representatives to let them know where they stand in the debate over the topic and how they believe future policy should be written.
More people than ever are also using their phones to call their doctors in order to find treatment. It’s the new (okay, not so new. It’s technically been around for 40 years), way patients are connecting with doctors to receive treatment. It’s called telehealth and it’s expected to do more than $30 billion worth of business annually by 2020. That’s a big number, but it’s nowhere near the $3.2 trillion that patient’s spent on care in 2015.
Still, it represents a growing segment of Americans that would rather pick up a phone to text or dial their doctor than go in to see one in person. Why is that? At SXSW this past March a number of reasons were put on full display.
There are hospitals all across the country. They’re in major metropolitans like New York City where New York-Presbyterian Hospital has 2,236 beds. Hospitals are also peppered throughout US suburbs. Their sizes can vary dramatically but they’re available, regardless of how many beds they have. It means suburban patients are often a short trip away from a hospital bed whenever it’s needed.
Compare this to Rural Hospitals where you’ll not only find hospitals serving locals with as few as 25 beds, but many communities that have seen their local hospitals close down. According to an article in USA Today, This exact issue has forced many in the small town of Richland, GA to travel 40 miles for care.
That’s why the National Advisory Committee on Rural Health and Human Services has spent time exploring Telehealth in Rural America. In places where care does exist, top specialists, often, do not. Telecommuting to doctors in these types of programs provides insight otherwise unavailable to patients.
According to the committee, “...Telehealth has the potential to be an important tool in health care delivery system reform and believes the technology can help rural areas take advantage of the ACA’s focus on improving access to care, enhancing quality, and reducing costs.” Only time and additional experience will show us whether those thoughts are true.
The LGBTQ Community
HIV may disproportionately impact segments of this community in comparison to others, but, in reality, healthcare for LGBTQ “isn't just about HIV. It's smoking, drugs, alcohol... a lot of lifestyle diseases." That is, at least, according to the LGBT Community Driving Digital Health Innovations panel at SXSW. Based on their research, and experience, “95% of health issues in the community are based on lifestyle, social exclusion, etc.”
Exacerbating the issue is that LGBT patients are reluctant to visit the doctor and end up being underserved. This according to not only the panel’s discussion, but also American Medical News. These patients sometimes postpone care out of fears of discrimination. In order to avoid the fears, some patients have shown a willingness to travel as far as 500 miles for healthcare.
“Some patients of family physician Robert J. Winn, MD, travel more than 500 miles for routine care at the Philadelphia health center where he works. Most are transgender. Others are lesbian, gay and bisexual.
“They live in East Coast towns that stretch from upstate New York to southern Virginia. And all are looking for the same thing -- a physician who understands them.”
There’s enough discord that having a doctor has even been considered “Straight Privilege” for some who fear medical care. These are the reasons why telehealth has become so important to the community. Telehealth offers this community the promise of access to sympathetic personal care in a private, personalized setting to help reduce the fear of discrimination. It’s why it has become the main user of a mobile app called pager, an uber like telehealth service that calls a doctor to you.
Tech Savvy Millennials
It isn’t just about tech. It’s about living through a recession in an age when healthcare costs are continuing to skyrocket. According to research conducted by Becker’s Hospital Review, 50% of Millennials avoid seeing the doctor to save money. It means that they are Googling everything first. Whether that be “why do I have a rash?” or “How much do meds cost?”, the fact is that they are turning to technology to research and address their health issues.
This always connected group also tends to find it difficult to find time to set up an appointment, travel to a doctor, wait in a waiting room, wait through delays, get called to an office, wait longer for the doctor to see them, and then finally be treated. Telehealth removes that roadblock. These are the reasons why 74% of Millennials would prefer a virtual doctor’s appointment. It’s another one of the many reasons why telehealth is such an attractive treatment option and business opportunity.
Telehealth vs Traditional health
According to research conducted by Harvard Medical School, your opinion on the cost of telehealth would depend on your belief of an opportunity cost. Telehealth appointments require more of a monetary investment, thanks to an additional telehealth provider fee, but they also cost you, on average, nearly two hours less time per appointment.
Including travel time, the average doctor appointment required 121 minutes of time, whereas the average telehealth appointment was a 15 minute investment. Based on estimates by Amwell, that’s the equivalent of more than $30 in savings. That means you payed as much as 200% more in opportunity cost than you did in the form of an actual visit. It’s a true representation of how time does, in fact, equal money.
While the adoption of telehealth has exploded over the last five years, from 350,000 users to an estimated 8 million by 2018, it’s important to remember that no two states define telehealth services the same. Here is an excerpt from the Center for Connected Health Policy’s 2016 paper on State Telehealth Laws and Medicaid Program Policies that begins to touch on these differences.
“Although each state’s laws, regulations, and Medicaid program policies differ significantly, certain trends are evident when examining the various policies. Live video Medicaid reimbursement, for example, continues to far exceed reimbursement for store and forward and remote patient monitoring. While there was an uptake in states reimbursing for store and forward and remote patient monitoring (RPM) between 2013 and 2015, in recent months that number has stagnated remaining the same since our last report was issued in July 2015. Some states, however, are making progress just as others are pulling back.”
Even as telehealth becomes more normalized, and as more apps like Pager find their way into society, critical monitoring will still be necessary, if not more so. The applications may however change. Instead of having to only monitor a refrigerator with vaccines in it, caregivers may need to monitor and collect data when transporting medications to patients. It’s why we’ve continued to innovate and one of the reasons why we brought our new DSB logger to market. When every point matters you have to be willing to answer every call, whatever reason they ring.