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Telemedicine has been most ordinarily deployed by health systems to deliver one-off specialist consultations (e.g., telestroke in EDs or elective specialist consultations during a PCP office). Along the journey from fee-for-service to value-based care, healthcare companies are discovering that telemedicine is often used as a clinical management tool across the acute episode of care, collaborating to reduce delivery costs within the hospital and coordinate care across settings after discharge.

Sizing Up Opportunities

The acute care landscape is growing, with salaries and expectations rising and provider supply and reimbursements declining. As healthcare shifts from fee-for-service to value-based care, telemedicine will create an increasingly significant role in helping to scale back costs and manage patient outcomes across the continuum of care. This may still be critical because of the U.S. population ages.

Telemedicine can extend high-quality care to hospitals and healthcare facilities of all sizes. For practices that are complex to recruit to, telemedicine offers skilled physician reports and decreases transfers. Conversely, large facilities can leverage telemedicine to vary their staffing mix or build surge capacity while delivering equivalent clinical outcomes to patients. 

Post-Acute Telemedicine

Sound Physicians is deploying telemedicine solutions to reinforce the continuity of care, streamline costs, and improve outcomes in skilled nursing facilities (SNFs), a healthcare setting that will surely enjoy having a national network of physician expertise at their fingertips.

According to Sound data, post-acute spending accounts for quite 60% of the entire costs within the acute episode of acute care, with nearly 40% coming from utilization and readmissions related to SNFs. As managing episode costs becomes more significant in value-based care, telemedicine is an efficient lever to reinforce the standard and consistency of care that happens when patients are discharged from the hospital and transition to subsequent best site of care.

Hospital readmissions end in thousands of dollars added to episode costs, and readmission rates from SNFs hover around 25%.

It’s inevitable that the dissemination of provider-to-provider telemedicine will still accelerate and play a number one role in managing the episode of acute care

With nearly two-thirds of those readmissions being clinically declined if a physician intervenes, there's a transparent scope for telemedicine to enhance processes and strengthen both clinical and financial outcomes.

SNFs vary widely in their physician coverage, with some hooked into a medical director, who may even see patients just one occasion every week, et al. relying exclusively on advanced practitioners. Having 24/7 telemedicine coverage and access to specialized physicians helps SNFs identify patient issues while they're still easy to deal with within the SNF and before they require readmission. Such physician access also helps SNF nurses and allied health professionals triage and more effectively determine if it’s necessary to send patients to the emergency department for evaluation.

If and when decisions are made to transfer a patient to a hospital emergency department for further evaluation, telemedicine can support the continuity of care by bridging the gap between the SNF and therefore the emergency providers. during this role, a telehospitalist can call the medicine physician on to provide full medical context and extra patient insights. This information allows the medicine physician to form better decisions because the patients arrive. Equally as important, the telehosptialist can communicate directly with the onsite hospitalist team to form better decisions about whether the patient must be readmitted to the hospital or be returned to the SNF. Workflow betterments like this are key to the success of value-based payment models as they create efficiency, reduce costs, and help providers deliver care that aligns with the preferences and values of the patients and their families.

The Telemedicine Journey 

Many hospitals and health systems have begun their journey in leveraging telemedicine to assist them to succeed under value-based care.

There are some sorts of telemedicine care that hospitals can readily implement on their own. In my experience, the edge is comparatively low for hospitals to determine remote specialist consultative services, whereby their specialists are extending their reach the first care practices around them.

Hospitals and health systems can generally accelerate their journey into telemedicine by joining with a national network of physicians who have deep expertise in developing clinical workflows. the proper partner also will make the shift to telemedicine seamless. The technology platform should be web-based and supply an intuitive user experience. What’s unique about Sound Physicians’ telemedicine program, and pivotal in our successful deployments, is that our platform is configured to satisfy the precise needs of hospital patients, both during and after their hospital stays, during a highly service-oriented way. In other words, evidence-based clinical protocols are configured in our platform to assist make sure that telemedicine providers are delivering equivalent consistent models of care as our onsite clinicians. Our technology platform is additionally configured to triage telemedicine queries consistent with the acuity, service level agreements, and request volume. this enables our telemedicine providers to specialize in what’s most vital – caring for patients. Bedside nurses, especially, are noting fast and trusted response times, and order accuracy that leaves less room for error.

I think it’s inevitable that the dissemination of provider-to-provider telemedicine will still accelerate and play a number one role in managing the episode of acute care. As hospitals and health systems swiftly find their thanks to value-based care, telemedicine is one very practical solution towards success.