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Telehealth and Population Health Management

Posted by Michael Greiwe, MD | December 1, 2018 |
Michael Greiwe, MD

 

 

As the healthcare paradigm continues to shift from fee for service to value-based care, population health initiatives have gained in popularity. Population health seeks to proactively change the clinical outcomes of a patient cohort. One study suggested that population health should include patient health outcomes, the patterns of health determinants, and clinical policies and treatments that link the two together.

The Centers for Disease Control and Prevention (CDC) defines population health as:

An interdisciplinary, customizable approach that allows health departments to connect practice to policy for

change to happen locally. This approach utilizes non-traditional partnerships among different sectors of the community – public health, industry, academia, health care, local government entities, etc. – to achieve positive health outcomes.


When we begin to imagine expanding care to entire populations by creating non-traditional partnerships, it seems logical to leverage the digital technology at our fingertips. By using smartphones and the Internet clinicians can begin to open new avenues of providing care to entire populations no matter where they are while creating new collaborative partnerships across a broad geography.

While we think of telehealth technology as a way to bring a remote clinician together with a patient in a virtual visit, it’s clear that there is a broader application for the technology at the forefront of population health management. Telemedicine uses the Internet to bring together providers and patients in our fragmented healthcare system. Virtual care can help clinicians manage patient populations in ways that improve health outcomes for an entire group. A recent Modern Healthcare article said:

Instead of connecting one person to one person for a single interaction, they connect to many, on an ongoing basis. To address system challenges like access, quality and dissemination of best practices, we need these more powerful linkages.

What are the benefits of telemedicine in a population health initiative? Are there specific populations that can benefit from the use of the technology?

 

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Benefits of Telehealth for Population Management

We know that population health can reach people in new ways that can eliminate the stresses of traveling to a remote care provider. We also know there are cost savings with telehealth that have been demonstrated repeatedly in clinical studies and anecdotal articles. But how can the virtual visit benefit specific population cohorts?

  • By increasing access to clinical care.
    Population health seeks to improve outcomes by eliminating barriers to treatment while ramping up preventative care to a vulnerable population. Increasing healthcare access points and removing barriers means that an at-risk patient population may be more likely to receive treatment. Simply put, if you bring healthcare to the patient, they will be more likely to engage with the clinician. We know this because there is a corresponding drop in no-show visits when telemedicine is utilized. It is in this way that telehealth is being used to help fight the nation’s opioid crisis. The technology is also being used to connect more frequently to elderly patients with chronic care conditions. While these are just two examples, telehealth is one way for us to use technology to extend care to vulnerable populations and ultimately change their health outcomes.
  • Improve care continuity by bridging care gaps.
    Population health seeks to influence populations by bridging care gaps between community services. We know that telehealth can eliminate some of the silos between service lines. It can also extend care to populations that run the risk of being neglected, such as rural communities. While care coordination has been a persistent problem in America’s health systems, telehealth can bridge geographic distances easily, bringing together specialists, primary care providers, ancillaries, social workers, and other providers. It is in this way that telehealth technologies can extend our reach by allowing care managers to talk directly to patients to counsel them on preventative treatments. Specialists can be consulted in a virtual visit that works just as well for the primary care provider as it does for the patient. Population health recognizes that to change health outcomes across an entire patient population, all of the systems within a care continuum must be brought to bear on the problem.
  • Engaging patients in their own health outcomes.
    Population health programs ultimately seek to engage patients in changing behaviors that will improve their health. Patient Engagement HIT says this is precisely how to leverage telehealth to improve outcomes. Disease managers and health coaches can do remote monitoring and patient counseling via the virtual visit. Without telemedicine, patients can wait weeks between clinical visits. With telehealth, clinical providers can access real-time biometric data between visits to watch for negative trends.

    It is in this way that telehealth reaches more patients more quickly, eliminating bottlenecks caused by a lack of provider access. Telemedicine Magazine predicts telehealth will eventually foster “100% reach” by engaging patients with wearable devices, remote monitoring, and virtual visits. When you consider that 90% of our $3.3 annual spend on healthcare is for people with chronic diseases, you can start to see the value of telehealth to manage long-term disorders. One study showed a corresponding drop in inpatient volumes for diabetic patients when telehealth was used to provide treatment for these chronically ill patients.

 

While there is enough evidence to show that telemedicine has delivered on these benefits, in fact, it is the population health initiatives themselves that have failed to reach their true potential. Telemedicine Magazine reports:

Population health ought to refer to approaches that improve health outcomes for entire groups of people. But it doesn’t. At least not yet. Rough estimates indicate program penetration rates of less than 10 percent in any given population. While this may appease the C-suite and shareholders, it won’t address the ever-increasing burden of chronic disease on the healthcare system. As diagnoses of diabetes and other diseases like hypertension and cancer multiply, employers, private insurers, and government-sponsored health programs are scrambling to care for their sickest, costliest members.

Is the problem that we’ve failed to make use of technology to extend our reach beyond 10% of a given population? Could telemedicine technology give population health initiatives the push they need to extend care further into the communities we serve?

OrthoLive offers a telemedicine application for orthopedic providers. Contact us to see a demo of our product.

 

Topics: "telehealth", "telemedicine", healthcare, population health, value-based care

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