California HealthCare Foundation has published Delivering Care Anytime, Anywhere: Telehealth Alters the Medical Ecosystem. The study focuses on the delivery of "care directly to consumers, at a distance, on demand" through videoconferencing, store-and-forward systems for imaging and data, patient monitoring and e-Visits. The report concludes that Telehealth "facilitates access to affordable, high-quality health care services that would otherwise be unobtainable." Telehealth usage is continuing to grow at a moderate pace.
Current State - Case Studies
WellPoint uses videoconferencing for improved care in under-served communities allowing for more rapid diagnosis and treatment of chronic disease. This is reducing "the cost of care by 6% overall - but 42% for follow-up care." Beth Israel Deconess uses videoconferencing for specialty consults, simulation training for interns and to connect interpreters in specialty sites and the ED, improving accessibility, efficiency and "early, proactive intervention for follow-up care".
Kaiser Permanente, Cigna, Aetna and other payers are offering e-visits for minor health problems, reducing office visits and improving patient/consumer communication with their providers.
Center for Connected Health monitors congestive heart failure, hypertensive and diabetic patients through devices communicating over the internet, reducing hospitalization, lowering chronic care costs and enabling "early, proactive intervention for follow-up care".
What is emerging in Telehealth?
Real-time on-demand care is available through phone-based physician consultations (case study TelaDoc ) and web-based physician consultations (case study American Well ).
Technology adoption is key to the success of Telehealth. The study found that the uninsured are wired in many cases and providers are becoming more technically capable. Shortages of providers and pressure on reimbursements will also help to advance Telehealth. To suceed, telehealth will have to overcome limited consumer awareness, provider liability exposure, state regulations, reimbursement limitations and limited capability for interoperability.
The types of use cases most amenable to telehealth application are minor in nature as well as a few major chronic conditions (such as weight monitoring for congestive heart failure patients).