Balancing Healthcare’s Iron Triangle with Telemedicine

blog_ipad_hand.jpgTelemedicine remains a controversial topic for both insurance companies and doctors. Money and quality of care are central issues as we strive to achieve a balance in health care’s Iron triangle of great access, high quality, and low costs. Telemedicine may be the cement that holds that triangle together.

In rural and obscure parts of the world where “top medicine” was once inconceivable, patients now have the ability to video chat with leading physicians to help diagnose rare illnesses for a fraction of what it would cost to travel to a specialist’s office. Additionally, with access to image storage and sharing, patients can keep track of their personal health information. Patients can connect with doctors of their choice and shop for second opinions. The general increase in access helps lower costs and drive patient happiness.

Not only does Telemedicine increase access, it can provide higher quality of care. Some critics are skeptical that higher quality is obtained. Can telehealth really provide the same quality of service a face–to–face visit can? Until recently the answer to that question was no. Now, modern technology allows doctors to see, speak and assess patients as well as have access to that patient’s medical history and imaging, all in real time with equipment equivalent or better in quality than at a typical clinic. Furthermore, discussion about the word ‘quality’ is very subjective. Quick and accurate diagnoses are not the only measures of quality; trust and costs are also critical. Trust is built by developing relationships through long-term interactions with doctors while reductions in costs are obtained by reducing the cost of a doctor’s time. Telehealth companies have begun to address both of these issues.

On-demand doctor services vet clinicians so patients do not have to. Patients can now be connected to trust worthy doctors in real time over video chat, eliminating transportation needs and costs as well as reducing wait times that under older appointment conditions could take up to a few weeks. The reduction in wait times increases the turnover rate per doctor. By allowing doctors to more quickly book check-ups, the cost of an individual patient’s visit can be reduced. Costs for virtual visits are “around $45, compared with approximately $100 at a doctor’s office, $160 at an urgent-care clinic or $750 and up at an emergency room.”

Costs could continue to fall for everday medical needs as more insurance companies and employers add telehealth coverage to their healthcare packages. Dr. Yaghmai, the founder of rural healthcare telemedicine provider Vigilias, noted that although telemedicine allows for expanded care to communities, traditional insurance companies are still very used to paying for medical visits completed within the walls of a physical hospital. “Many private insurers are not interested in providing coverage for patients seeking care outside of these traditional facilities” says Dr. Yaghmai. Vigilias was founded in 2014 to provide modern communication technology to rural hospitals and providers to offer their patients local access to care that once required a long trip to a major city. Challenges arose surrounding the clunky and out-of-date telemedicine tools currently available on the market. Since partnering with DICOM Grid, Vigilias has gone from 17 different platforms to DG suite’s all-encompassing cloud solution.

Dr. Yaghmai initially planned to use local hospitals’ EMRs to exchange and view medical imaging, however, he quickly discovered that some didn’t have EMRs, some were difficult to use, most were not image enabled, and many do not have remote log-ins. The flexibility of cloud architecture makes it easy to bridge the gaps between the technologies that are already in use at organizations

Insurers will soon need to catch up with technology and change with the time as,  “Nearly three-quarters of large employers will offer virtual doctor visits as a benefit to employees this year, up from 48% last year [and] Web companies such as Teladoc, Doctor on Demand and American Well are expected to host some 1.2 million such virtual doctor visits this year, up 20% from last year, according to the American Telemedicine Association.”

Do you think telemedicine seems to be the new frontier for innovation, quality, and distribution of healthcare and health care services?

Eli Auerbach, Intern

About Eli Auerbach

Eli Auberach was the Strategy and Business Development Intern for Ambra Health during summer 2016.

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