Filling In The Hospital Care Gap In America

Jason Povio is President and Chief Operating Officer for Eagle Telemedicine and an expert in healthcare operational excellence.

Physicians are in short supply in the U.S. A report by the Association of American Medical Colleges (AAMC) estimates a total shortage between 37,800 and 124,000 physicians over the next 12 years. Shortages include up to 48,000 primary care physicians and up to 77,100 non-primary care physicians. These statistics live within two other key trends impacting future health care delivery: patient demand for specialty care is on an upward trajectory with increased chronic disease presence, and there is the continuing need to do a better job for underserved and rural communities.

The American Medical Association (AMA) survey report shows 85% of physician respondents indicate they currently use telemedicine, with some using a combination of in-person and virtual care. More than 80% reported that patients have better access to care since using telemedicine. Physicians are consulting with patients from their clinic offices or homes. On site at hospitals and hospital systems, telemedicine is gaining traction as a relief valve for physician shortages, staffing coverage around the clock, specialty care and serving rural communities.

The Business Case For Telemedicine

To survive and thrive economically, I believe hospitals need to make in-patient telemedicine a standard part of the spectrum of health care services. When I worked as an operational leader for a large health care system based in the Southeast, I saw the value telemedicine could deliver firsthand. I now help other companies embrace telemedicine programs to balance out their care delivery strategies and have seen the following benefits:

Cost Savings: Telemedicine can provide significant cost savings to a hospital system, often costing a fraction of a full-time staff physician. When used in a hospital system, the telemedicine costs can also be shared by multiple hospitals, making the cost less for any one hospital’s bottom line.

Patient Retention: When a patient must transfer because the service is not available in a particular hospital, it contributes to lost revenue. Telemedicine virtually connects patients to physician specialty care, keeping the patient on site. The majority of facilities across the country have the infrastructure to support these patients receiving their care close to home and are only lacking the physician support to drive care.

Growing Demand: Telemedicine is a solution for hospitals that do not have the budget to keep full-time staff in so many specialties and sub-specialties. If a patient needs a diagnosis late at night after an accident, for example, a radiologist may not be physically present but teleradiology can provide this service. In fact, the AMA physicians’ survey reports that 49% of physicians use telemedicine specialty care.

Work-Life Balance: Telemedicine can provide work-life balance and help retain physicians. By eliminating commute times and working from a satellite office, more of their day can be spent with patient care. In rural communities, this can help provide needed specialty care without having to wait while a physician travels long distances to get to a small hospital. Also, allowing physicians to work on-demand means more specialty care will be available at varying times, a benefit to the patient and hospital revenue.

Serving the Underserved: The Health Resources and Service Administration (HRSA) reports there are 3,450 medically underserved areas/populations (MUA/Ps) in the U.S. Rural health facilities struggled with a lack of workforce to meet pandemic patient demand and further stressed an already thin operating margin. To lessen service stresses, important in rural areas, the CMS relaxed clinical site rules to enable more telemedicine use so patients did not have to risk exposure. It enabled clinical services to continue and the results have prompted a long list of policy improvements to secure rural hospitals’ long-term viability.

How To Incorporate Telemedicine

Launching a telemedicine program at a hospital–whether urban or rural–follows basic business principles: creating a business plan with market intelligence to identify underserved specialties or services you want to address; patient load; staffing and training considerations; and general patient receptivity to virtual care.

Additionally, within the hospital infrastructure, you must gauge what you need to fully integrate telemedicine into your system. This entails carts with screens that can accommodate teleconsults, the level of broadband connectivity and speed available and the comfort level of physicians and staff with using electronics related to telemedicine.

Choosing a telemedicine platform is also a consideration. It can be wise to select a program that integrates seamlessly with the hospital’s existing Electronic Medical Records (EMR) software so that hospital processes and policies can be automatically integrated into the telemedicine providers’ practice. This can help avoid additional technology and administrative overhead.

Overcoming Telemedicine Challenges

Deploying telemedicine, like any new strategy, can have its challenges. Certainly, nothing replaces on-site care. However, with the rising physician shortages, telemedicine is quickly showing value to expand physician access and availability, especially to underserved communities.

The most successful programs use “pods” of physicians dedicated to a particular hospital. This avoids the challenge some have seen with a more “Uber-like” telemedicine approach where the next physician in a large queue is assigned to respond without the valuable context of the hospital it is serving. Programs that use this less personalized approach often fail to gain staff and patient acceptance.

Training is another challenge that must be addressed when adopting telemedicine. Without adequate training for on-site staff as well as the telemedicine providers, programs may fail to get successfully off the ground. Nurses and on-site physicians need to help patients understand how telemedicine will be utilized in their care. Telemedicine providers too must have training in the best way to deliver virtual care with an engaging “webside” manner where the screen melts away.

With the right program model and training, telemedicine can be one answer to the physician shortage. It improves care access at a cost rate that not only is economically beneficial but provides a stronger foundation for health care in the future.

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