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8 Key Telehealth Trends in 2019

July 15, 2019

By Scott Files, contributor

Across the country, telehealth is changing the way physicians practice. As consumer demand increases for the convenience of virtual health visits, so has physicians’ acceptance of the technology.

“Telemedicine is bound to continue booming,” said Peter Yellowlees, MBBS, MD, past president of the American Telemedicine Association and chief wellness officer at the University of California, Davis Health in Sacramento.

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8 current trends in telehealth and telemedicine

1. Steep growth in physician adoption

Physician adoption of telehealth increased 340 percent from 2015 to 2018, according to American Well’s Telehealth Index: 2019 Physician Survey. Additionally, 69 percent of physicians indicated a willingness to try telehealth. The survey estimates by 2022, as many as 590,000 physicians will be using telehealth.

“Physicians are starting to welcome the disruptive approach to health care and are slowly realizing its benefits—cost improvements, access to remote people or to those without physicians, as well as a fun way to see patients via tech, which can help with burnout,” said Mia Finkelston, MD, medical director of American Well, which offers telemedicine technology solutions.

“We are at the tip of the iceberg, and the more that physicians use and realize telemedicine, the more positive use cases will come out of it for physicians and patients alike,” she said.

2. Health systems riding the virtual wave

Many health systems, such as UC Davis Health and Nemours, are offering virtual health visits. More than 650 Nemours clinicians see patients virtually, either for 24/7 urgent care or prescheduled subspecialty visits. Some Nemours physicians have championed telehealth while others are slower to embrace change.

“Many of our physicians absolutely love it and are leveraging it to improve access and convenience for their patients,” said Carey Officer, operational vice president of Nemours CareConnect in Jacksonville, Florida. “They are also finding value in the ability to have more flexibility with their schedule by having the opportunity to connect with patients from their home, reducing overhead and reducing ‘windshield time.’”

Nemours starts physicians off with one case and one-on-one training. Officer listens to their concerns and solves technology problems for the doctors.

3. Flexible scheduling options

At some organizations that offer virtual health visits, physicians can log in and accept virtual visits when they are free, and employers also may hire physicians full-time or part-time to make virtual visits, explained Elisabeth Farnum, MD, assistant medical director for Doctor on Demand in San Francisco.

“This last year, we hired a lot of new people,” Farnum said. “The shifts are low stress.”

Asynchronous visits, also called store-and-forward visits, can create even greater flexibility, enabling the physician and the patient to conduct the visit when it is best for them, not at the same time. At the recent Value-Based Care Summit on Telehealth in Atlanta, telehealth lawyer Nathaniel Lacktmann called asynchronous telehealth “the next big thing in consumer-oriented telemedicine,” touting its adaptability and cost efficiency.

4. Reducing administrative tasks

“For the doctor, [virtual visits] are more efficient than seeing patients in person,” Yellowlees said, adding that physicians practicing telemedicine have fewer administrative hassles and can document while conducting the visit.

Additionally, the physician can work from home and book virtual health visits at convenient hours. Most virtual visits take place after normal business hours. Physicians can also practice telemedicine part-time.

While telemedicine is covering more and more conditions, companies like Doctor on Demand charge a single fee for every consultation. Therefore, Farnum said, doctors do not need to code.

5. Increasing access to care

Much of the increase for physicians and telemedicine comes from patient demand, Yellowlees said. Patients do not have to take time off from work or wait in a clinic office to be seen. UC Davis Health offers both in-person and virtual health visits, and some patients do both.

“We must make it easier on our patients and families to access the care they need in their local communities and from the comfort of their home,” Officer said. “As technology advances to allow us to do more from the home and reimbursement models continue to evolve, we will see greater adoption of telehealth tools to not only meet and improve access but also improve outcomes.”

For years, telemedicine has been talked about as improving access for rural dwellers, but now it is catching on for people in all settings, particularly Millennials, Finkelston said.

Additionally, connecting rural hospitals with their rural patients cannot happen if the community does not have access to fiber broadband, the necessary infrastructure to conduct telehealth services, said Jim Turner, CEO of Intelligent Fiber Network in Indianapolis.

6. Improving reimbursement

Long a deterrent to telemedicine, reimbursement issues have mostly resolved, with more payers adding telemedicine to their benefits, more states passing legislation for telemedicine parity reimbursement, and the CHRONIC Care Act, passed in 2018, allowing Medicare dollars to cover the remote care of chronically ill patients.

“In some states, reimbursement is at the same rate as in-person care,” Yellowlees said. “A lot of people doing telemedicine are working with a private company or big health systems.”

Physicians are increasingly being paid capitated rates, a per-member, per-month payment, Yellowlees said. Telemedicine can be attractive to managed care plans and accountable care organizations.

Some physicians are also using telemedicine as part of their concierge practice, Yellowlees reported.

7. Reducing risk

Malpractice has been sometimes raised as a concern in regards to the practice of telemedicine.

“All major disciplines have developed formal guidelines, and the American Telemedicine Association is a driver of guidelines,” Yellowlees said. “If you follow guidelines and good clinical practice, the insurance companies see this as a low-risk type of medicine.”

Physicians should notify their medical liability carriers if planning to provide telemedicine services.

Farnum said most calls are about low-acuity problems, reducing risk, and the physician can refer to the emergency department or call 9-1-1 from afar.

8. Continuing licensure challenge

Licensure in the state where the patient is located presents some challenges to practicing telemedicine. Telemedicine providers often use software that fields visit requests to physicians licensed in the state where the patient lives. However, the physician should double-check the patient’s physical location.

Despite the licensing roadblock, physicians and telemedicine are catching on.

“This is clearly the future of medicine,” Yellowlees concluded. “The first telemedicine consultation was done in 1959. This is not a new thing. But it has passed the tipping point.”

8 Physician Trends to Watch in 2019

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