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Telehealth and The Triple Aim

Posted by Michael Greiwe, MD | November 2, 2018 |
Michael Greiwe, MD

The United States has the most costly healthcare system in the world, according to the National Healthcare Expenditure Projections, 2010-2020. These costs are rising from the current rate of 17% of our gross domestic product (GDP) to almost 20% by 2020. Some of the precipitating factors driving these costs in the U.S. include:

  • An aging population.
  • Increasing longevity.
  • A rising burden of chronic long-term health problems in our citizens.

In response to rising healthcare costs, the Institute for Healthcare Improvement developed the IHI Triple Aim. The Triple Aim set its sights on a framework with three goals:

  • Improving the patient experience of quality and satisfaction in healthcare.
  • Improving the health of an entire population.
  • Reducing the costs of providing healthcare.

Part of the problem with achieving the Triple Aim a long-term solution to a growing problem is that many initiatives can only tackle one or two of these three tenets simultaneously. But there is one tool that can conquer all three: Telehealth.

How Telehealth Can Achieve The Triple Aim

One of the key tenets to the Triple Aim is the concept and practice of telemedicine as a technology solution that can be applied to affect all three areas of IHI’s initiatives simultaneously. An article in EHR Intelligence points out, “In some shape or form, telemedicine can be used in any aspect of healthcare delivery at a lower case while driving up quality simultaneously.”

Telehealth technology has been around for decades, so there is a wide volume of recording metrics that show the positive outcomes that stem from telehealth technology. The nation’s largest health system, the U.S. Veterans Administration (VA) has used telehealth for years, continues to rank the technology highly, and also continues to expand the service lines where telehealth is offered.

Today’s patient demands access, and telehealth improves the patient experience by enabling access to treatment more quickly while eliminating the hassles of traveling to the physician’s office. Telehealth can also extend specialist treatment to rural hospitals, reaching patient, literally, where they live.

It’s the technology itself that has enabled these programs to bring real benefit to patients. Healthcare IT News says:

Connected health is foundationally about the ability to improve care through better connectivity. Such connection through telemedicine technologies facilitates patient-to[physician and patient-to-caregiver communication – providing on-demand access outside of healthcare’s four walls, regardless of patient or provider location.

Telemedicine can fill the gap between patient need and healthcare’s promise of wellness.

How can telemedicine positively impact IHI’s Triple AIM?

  • Improving patient satisfaction.
    Telehealth visits score consistently high for patient satisfaction. There is a consistent body of evidence over the past decade that the virtual house call ranks highly among consumers. One study showed between 94 and 99% of telehealth patients was satisfied with the experience and one-third preferred telemedicine over the traditional visit. Today, more Americans are willing to try telehealth than ever before.
  • Improving population health.
    Telehealth technologies can be applied across a single type of patient population to improve their lives. Whether it is remote monitoring and education of diabetics or helping elderly shut-ins stay connected to a service framework, telehealth improves population health.
  • Reducing healthcare costs.
    According to one study, 93% of healthcare providers that use telehealth say it reduces their costs. Telehealth reduces clinical overhead costs while improving the patient’s time invested in the appointment. One study showed the average cost of a telehealth appointment is $39, or about one-third less than the traditional visit.

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But what is there in the current healthcare climate that makes the Triple Aim so necessary and telehealth’s promise so expansive?

Fixing What’s Broken

Today’s patients are experiencing longer wait times to receive treatment. That’s because the current provider shortage is worsening exponentially; the latest numbers show shortages of 100,000 providers by 2030. The hardest hit areas will be the rural markets, where populations are poorer, yet have to travel the farthest to receive care under traditional healthcare models.

The push to expand healthcare with urgent care clinics attempts to remedy provider shortages. While these “minute clinics” serve to help with non-emergency care, they are typically staffed by mid-level providers, i.e., not physicians. While walk-in clinics fill a necessary market niche they do nothing to improve the quality of care because they don’t offer the depth of clinical expertise found in a physician-to-patient encounter. These visits are generally not sent to primary care providers, which further fragments healthcare’s silos when an integrated and more coordinated approach to care is needed.

As for population health initiatives, these frameworks were designed to take an overly bloated reactive and expensive healthcare model and shift it away from volume to value. Population health models seek to proactively retrain an entire population subset toward a wellness mindset by teaching them healthcare best practices aimed at reducing inpatient admissions.

Telehealth is perfect for remote patient education models. Just this month Modern Healthcare reported on a population health initiative that used telemedicine to connect specialists and primary care “spokes” across a region to teach and provide counsel on hepatitis C treatment and preventative strategies. Called “Project ECHO,” the initiative was billed as a collaborative population health model for telementoring. Ultimately, it is a conduit to improved proactive patient care. The article stated, “Once shared, that knowledge takes on a life of its own, growing and moving in all directions.”

The benefit is a population health model that could potentially use telehealth technology to, “treat devastating conditions like opioid addiction, rheumatoid arthritis, heart disease, HIV and hepatitis.”

Putting Telehealth to Work in Your Practice

Telehealth’s impact on IHI’s Triple Aim cannot be discounted. Whether telemedicine is being used to increase access to care and improve outcomes, teach healthy living to a population, or just to reduce overhead in an overburdened independent practice, the technology has been well-documented as an effective tool to combat some of the toughest problems health systems are facing today.

OrthoLive has a telehealth solution for orthopedic practices. Find out how your clinic can achieve the Triple Aim with our low-cost, HIPAA-compliant telehealth solution. Contact us today.

Topics: "telehealth", "telemedicine", healthcare, business value, Triple Aim

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