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Solving Healthcare’s Supply and Demand Problem with Telehealth

Posted by James Baker, Chief Medical Officer | March 7, 2019 |
James Baker, Chief Medical Officer

Telehealth is about to move from faddish adoption of cool technology by hospitals to a strategic imperative for a healthcare system strained to its breaking point by provider shortages and a host of other factors. We anticipate that the unusual influx of pressures will force the remaining telehealth holdouts to learn this new way of providing virtual visits to their patients across numerous specialties.

Telemedicine offers clinicians a new way of responding to the increasing demand for medical care. As the Baby Boomer population ages, costs rise, and shortages of primary, and specialty doctors, as well as nurses and midlevels loom, telehealth offers providers a new way to cope with unprecedented demand.

Here are the problems we’ll be facing in the next decade, and the best way to stretch our healthcare safety net without breaking it.

A Lesson in Healthcare Supply and Demand, 2030

We’re about to enter unprecedented times, where our healthcare systems will be strained possibly to breaking by four simultaneous factors. These factors could be mitigated through the adoption of new workflows that incorporate telehealth technology. Without unprecedented measures we run the risk of providing substandard care – or possibly no care at all.

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The U.S. healthcare paradigm about to feel pressure from four key areas.

1. Healthcare Provider Shortages
An Open Minds Executive Briefing reported on the coming shortage of nurse practitioners, home care workers, and physicians over the next decade. These shortfalls are going to be felt in nearly almost every specialty. For example:

  • Nurses
    The American Association of Colleges of Nursing projects a need for 649,1000 replacement nurses in the field by 2024. The number of qualified candidates will fall far short, with pain being felt most strongly between 2009 and 2030. With fully 55% of the current nursing workforce-aged 50-or older, it’s clear that retirement will exact a big toll on our current resources. As these nurses leave the field, look for increasing stress and lowered care quality, as our remaining teams struggle to handle the load.
  • Primary and Specialty Physicians
    The Association of American Medical Colleges (AAMC) reports that the U.S. healthcare system will labor under shortages of up to 120,000 physicians by 2030. This includes a shortage of up to 49,300 primary care and 72,700 specialty providers.
  • Home Health Aides
    Healthcare Finance predicts a shortage of 446,300 home health aids and 95,000 nursing assistants by 2025. An Open Minds Executive Briefing states that 50% of the population currently is over 65 years old and needs some form of long-term support. By 2025 that population will have doubled.

2. Aging Populations

“The budgetary and policy implications of this demographic shift represent two of the greatest challenges faced by federal and state governments today. An aging population will place intense stress on our healthcare system, its funding sources, and American families.”
University of Pittsburgh
The Stern Center for Evidence-Based Policy
Addressing the Health Needs of an Aging America

The AAMC suggests that the U.S. population generally will grow by 11% by 2030. Healthcare Dive points out that the number of Americans aged 65 or higher will increase 8% by 2030. One-third will have at least one chronic ailment. That’s about 59 million people. Yet we know this growing demographic places increasing value on remaining independent despite the fact that 80% of older adults have one chronic disease and 68% have at least two.

3. Community Hospital Closures

There have been 97 closures of hospitals serving rural communities since January 2010. Healthcare Dive says rural residents are five times as likely as urban dwellers to reside in a region with a primary care physician shortage. Georgia Health News says these closures have been devastating to communities both economically and in terms of healthcare care outcomes; rural communities often have the highest rate of chronic diseases like diabetes.

4. Rising costs

PWC calls it our “unsustainable healthcare costs,” predicting another 6% rise this year. While healthcare providers have initiated efforts to reduce utilization, PWC says our focus should be on cutting costs. The continual cost upswing has translated into higher insurance premiums and out-of-pocket costs for both employers and patients.

It is the tumultuous pressure of these factors that necessitate a new look at an old technology – telemedicine.

Working Smarter with Telemedicine

“One observation I have about the workforce issue conversations that there is rarely a discussion of how to use technology to address the issue—a strategy that is common in other fields.”

Monica E. Oss
Open Minds Executive Briefing
Workforce Problems? Technology as Strategy

Health Affairs points out that it’s not really supple and demand that’s the problem here. They call it a “demand-capacity” mismatch, stating:
Primary care practices could greatly increase their capacity to meet patient demand if they reallocate clinical responsibilities—with the help of current technologies—to non physician team members and to patients themselves. Physicians often complain that they are responsible for tasks that team members with far less training could perform.

Telehealth allows healthcare providers to expand capacity with a low-cost technology implementation that is as easy to use as your cellphone. Ironically, other industries have been leveraging technology to work smarter. The Harvard Business Review provided a framework for the best applications of technology to solve business problems. The author suggested that technology could be used to:

  • Amplify staff
    In the case of telemedicine, virtual visits can increase patient volume and cut the amount of time spent on in-person visits. The technology stretches the efficiency of existing providers so that they can see more patients, more quickly. It can improve the efficiency of care coordination and even cut down on no shows.
  • Improves consumer interactions
    Telehealth can increase contact with patients by following them into their homes to coach, train, and monitor treatments. Studies have shown both improved outcomes and decreased costs by using remote monitoring tools and the virtual visit to engage patients on their own turf.

Telehealth can be used to circumvent provider shortages by stretching the healthcare service delivery net. It can help us cut costs and improve access to care in rural areas. Studies show it is a particularly useful tool for reaching seniors with chronic diseases in their homes. While we know that telemedicine cannot solve every problem healthcare will be facing by 2030, there is growing buzz in the market that this technology will help lessen some of the burdens we’ll be feeling over the next decade.

Talk with OrthoLive about how to leverage telehealth in your practice.

Topics: "telehealth", "telemedicine", doctor-patient relationship, digital health, tipping point, rural health

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