Commonwealth Fund Case Study Highlights Telehealth

Remote patient monitoring—better known as telehealth—can facilitate communication between patients and their caregivers and engage patients in managing their own care. A new set of case studies published by the Commonwealth Fund highlights three successful telehealth programs:

• The Veterans Health Administration's Care Coordination Home Telehealth program, which demonstrates the possibility of implementing telehealth on a broad scale and achieving cost-effective, high-quality outcomes for chronic care patients. 
• Partners HealthCare's Connected Cardiac Care Program for heart failure patients, which has generated an estimated $10 million in savings since 2006 for more than 1,200 enrollees. 
• Colorado-based Centura Health at Home, which has merged a clinical call center with telehealth to improve outcomes for older patients after hospital discharge. 

Each of the programs started as a pilot with the support of a small group of advocates who believed in the technology’s potential for offering improved care for a targeted population. Early lessons include promoting a culture of openness and preparedness; using a multidisciplinary team-based approach; establishing leadership support; minimizing barriers to patient enrollment, like cost; and including nonstandard measures, like patient experience and staff satisfaction, in program evaluations.  Other commentary and research on telehealth point out the natural alignment between telehealth and the patient-centered medical home - a concept some employers are already utilizing to help manage employee population health.

Insurers Embrace Virtual Doctor Visits

A joint Kaiser Health News/USA Today story reports that insurers such as UnitedHealthcare, Aetna and Cigna, and large employers such as General Electric and Delta Air Lines are getting on board, pushing telemedicine as a way to make doctor "visits" cheaper and more easily available. Proponents also see it as an answer to a worsening doctor shortage. But some physician and consumer groups worry about the trend.

Although telemedicine developed more than 40 years ago as a way to deliver care to geographically isolated patients, its growth was slow. That's changed in the past decade thanks to the development of high-speed communications networks and the push to lower health costs.

Carmen Balber, a spokeswoman for Consumer Watchdog in Santa Monica, Calif., is concerned that lower co-payments, and other incentives, will spur consumers to see doctors or nurses online just to save money. "People will choose the more economical option, even if it is not the option they want," she said.

Employers, however, say they're getting mostly positive reviews.

"Our employees just love the convenience, the low cost and the efficiency," said Lynn Zonakis, managing director of health strategy and resources at Delta Air Lines, which offers NowClinic to some employees for $10 a consultation.