ClickCare Café

Even in Big Data Age, Healthcare Collaboration is Still About Basics

Posted by Lawrence Kerr on Wed, Sep 16, 2015 @ 07:30 AM

Baystatemedicalcenter

 

We are in an age when data matters more than ever. It affects how much physicians earn, how much hospitals make (or lose) and whether treatment plans evolve based on efficacy.

Accountable Care Organizations (ACOs) are under increasing pressure to make the data work out. Whether in managing EHRs/EMRs, doing analysis of big data, working with the Medicare Shared Savings program, or handling fee-for-performance models, hospitals must be more sophisticated than ever before.

It is an almost impossible challenge for hospital administrators to manage all of these intricacies and also keep the common sense and fundamentals of "good medicine" alive. So we were inspired by some recent comments by Joel Vengco, vice president and CIO of Baystate Health in Massachusetts.

To give you a sense, Baystate Health is huge. It is a six-hospital health system with 80 medical groups, serving 900,000 patients across four counties.

And yet - when asked what the biggest challenge for Baystate Health as an ACO is, Mr. Vengco said:

"The first big hurdle is just really creating the necessary environment for collaboration across the continuum of care and the region... Everyone is responsible for that patient population... So it’s really back to the basics of collaboration, which is in many ways a fundamental principle, but is also sophisticated and complex with regard to an operation like that." 

This is definitely representative of our experience with hospitals that use ClickCare -- and those that don't. There is a lot of complex analysis that happens, but ultimately, success in an ACO setting comes down to excellent care coordination, superb healthcare collaboration, and healthcare providers across the continuum of care.

It's not easy work, but there are tools (like some telemedicine platforms) that can help. It's work that's done person by person, day by day.

 

For our best advice on creating that environment for healthcare collaboration, get our free Quick Guide:

 

ClickCare Quick Guide to Medical Collaboration

 

 

 

Photo of Baystate Medical Center used under Creative Commons rights from orlandosworld on Flickr

Tags: accountable care, healthcare collaboration, ACO

3 Shifts in Medicine (and How It's Paid For) You Need to Watch

Posted by Lawrence Kerr on Tue, Jul 07, 2015 @ 07:00 AM

shiftsinmedicine.jpeg

Healthcare in the US is almost unfathomably complex. Plus, it's always changing, such that it can be very hard to notice trends in any useful way.

However, we are at an especially volatile and important moment in medicine, with the reverberations of the Affordable Care Act still playing out. Just in the past few weeks, I've noticed a few trends that I think every ACO, every hospital, and every medical provider should have their eyes on.

3 shifts in medicine that will probably impact you in the next year:
  • Insurers will be demanding "more" from providers and hospitals.
    On one hand, insurers are squeezed by higher-than-expected costs of the newly insured. Many are now requesting rate increase approval from the government. As the New York Times reports, "The rate requests, from some of the more popular health plans, suggest that insurance markets are still adjusting to shock waves set off by the Affordable Care Act." On the other hand, many insurers are merging, which gives them more leverage over hospitals and providers.  The pressure to increase revenue and cut costs, combine with increased power from mergers may well add up to more demands on providers and hospitals.
  • Non-traditional care contexts are becoming the norm.
    Because of shifts in what is able to be reimbursed under the Affordable Care Act, there are new delivery mechanisms being pioneered. For instance, there is a current boom in diet clinics, due to ACA reimbursement for obesity consultations and treatment. It's likely that as care outside of doctors' offices increases (with other medical providers being the ones actually interfacing with the patient), healthcare collaboration (especially using telemedicine tools) will become more important. Collaboration will need to happen more, and across the spectrum of care, in order for patients not to fall between the cracks.
  • Home care is a growing segment of medicine, and we're (mostly) not doing it well.
    Data is beginning to suggest that there are more homebound people than ever before, and they're sicker. Plus, there are more caregivers who are older family members and need support themselves. This type of dynamic means that medical providers are responding, and finding ways to provide care at home. For instance, there is a growing group of geriatrics practices that make housecalls. And if those housecalls have to be made by specialists because there is insufficient technology to allow collaboration at a distance, that's going to be unsustainable. If these trends continue, we'll need to find ways for the people providing the home care to be supported by other medical providers, in efficient and effective ways.

For decades, medical providers had the luxury of ignoring macro trends. These days, however, I think that we ignore these dynamics at the peril of ourselves, our practices, and our patients. For us to act with wisdom, sustainabily, and in service of good medicine, we must act with these things in mind.

And really, that is more of a privilege than a burden.

 

To learn how iClickCare can help you adapt to these shifts, click here: 

 

Tell me more about iClickCare

Tags: accountable care, homecare, ACO, affordable care act, home care, affordable care act compliance, insurance,

Reducing Risk for Next Generation Accountable Care Organizations

Posted by Lawrence Kerr on Tue, Mar 17, 2015 @ 07:30 AM

NextGenACOs

Last week, the Centers for Medicare & Medicaid Services made an announcement that is really significant, but perhaps not surprising. They are launching a program that will further cement managed care and even more deeply link performance and payment -- the Next Generation ACO Model.

It is designed for ACOs that are experienced in coordinating care. The announcement notes: “It will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Shared Savings Program (MSSP). The goal of the Model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.”

Part of the announcement is the expansion of telehealth services. This further cements the use of iClickCare, not as flourish or a "nice to have", but as a routine way of taking excellent care of patients. As the American Telemedicine Association clarified: “The decision is particularly significant because under this new model, Medicare telehealth services can be covered without regard to longstanding rural and institution restrictions, requiring a beneficiary be located in a rural area and served at a health facility. For the first time, telehealth coverage will be extended to 80 percent of Medicare beneficiaries living in metropolitan areas and from any service originating site, such as their home.”

Only 15 to 20 ACOs are expected to participate, but the message is becoming increasing clear:

Reward and risk are, increasingly, being transferred to the provider.

Are we moving back to a time before Medicare existed? Of course not but it seems that there is more recognition that the provider and the patient are part of the solution rather than part of the problem. We wonder why this is being approached in such a small way, but we also recognize that it only takes the tiniest of sparks to start a bonfire that will last the whole night.

iClickCare welcomes the opportunity to help ACOs reduce risk. More than care coordination, real risk reduction requires collaboration, which is iClickCare’s core mission. The deadline for a letter of intent for the Next Generation program is May 1, 2015, just 45 days away. If you are applying, contact us and we'll explore how we can support you. 

The benefits and savings of iClickCare have existed for decades. Now, the difference is that this type of coordination of care and strategic collaboration are indispensable -- and supported by the government. Now, more than ever, is the time.

 

As telemedicine becomes more important for managing risk, coordinating care, and decreasing the costs of care, you can try iClickCare for free: 

Try the iClickCare 14-day evaluation

Tags: telemedicine, telehealth, accountable care, ACO, managed care

Burn Down Capitated, Managed, and Accountable Care?

Posted by Lawrence Kerr on Mon, Mar 09, 2015 @ 07:00 AM

contributionship

Last weekend, I visited Philadelphia to see my daughter. As I walked along one cobblestone street, I noticed a metal plaque with four interlinking hands on some of the oldest homes. It was familiar to me, and in reminding myself of the history of these placards, I realized something fundamental about the changes in medicine.

But let me back up. In fact, let me back up to Benjamin Franklin in 1752. In response to the horrific fires in the young city of Philadelphia, Benjamin Franklin put together a “contibutionship” to take care of rebuilding after the fires. Modeled after a London firm, policyholders of this contributionship formed a mutual insurance company to share burdens in the case of fire. A contributionship member placed a medallion or plaque on the house. When a fire occurred, the paid firemen raced to the scene and put the fire out. If there was no medallion, they watched the property burn. Of course, risk was managed: there could be no trees on the property of the houses with medallions.

Capitated care, managed care, accountable care are all built on the same principle. Benefits (care) are given, but risk is shared by everyone involved. The only difference is that there are a lot more middlemen and statisticians in the healthcare system. And rather than each member paying directly, the member pays taxes or a premium to the government or insurance company.

Management of that care involves finding a better way to decrease costs. Instead of requiring no trees on the property, healthcare management focuses on efficiencies and expensive outcomes. iClickCare focuses on both the quality and savings of coordinated and collaborative care. Everyone “at risk” -- institutions, providers and patients themselves -- can contribute to the outcome by safe handoffs, time saved, and decreasing waste.

The nearly unspoken caveat is that everyone must behave differently. Not only the providers need to change, the patients need to do so as well. An excellent commentary on that piece by Christensen, Flier and Vijayaraghavan is here.

So as these concepts become even more crucial for us all to move towards sharing the burden of disease, managing risk, decreasing costs, and providing good care, these are the definitions that will be crucial:

  • Capitated care:  By the head. The payment for insurance to care for a member for a fixed fee per year.
  • Managed Care:  Adding tools such as approvals for procedures, a panel of physicians, and occasionally rationing of services. Remember the rule about trees in the contributionship? HMOs have those kinds of provisions.
  • Accountable Care Organization:  An organization which pays by capitation or fee for service, but adds penalties and rewards based on quality measures from the Centers for Medicare and Medicaid Services.
  • Managed Medicaid:  A healthcare payment system by states which enrolls the poverty stricken in a capitated plan. Payments to providers can be fee for service or capitated.
  • Prepaid Health Plans:  Same as above. Prepaid group practices developed from 1930 through 1960.
  • HMO (Health Maintenance Organization):  A prepaid health plan but based on the Health Maintenance Organization Act of 1973. Payment for services is only made within the network of the plan after referral from a primary care provider.
  • PPO (Preferred Provider Organization):  A prepaid heath plan in which the patient is able to make self referral within and without of the network of the plan.
  • EPO (Exclusive Provider Organization):  A hybrid of HMO and PPO. The patient selects the provider without a primary care referral, but the care must be exclusively within the network of the plan.
  • BPCI (Bundled Payments for Care Improvement):  Not prepaid, but retroactively paid services to groups of providers to force alignment of incentives. A managed care program with retroactive payments instead of prospective payments. 

When all is said and done, though, medicine should come down to a partnership with the provider and the patient. The doctor, the nurse, the aide and the therapist are a team with the patient and for the patient. Any system will only work when it is also really bought into by the patient. For as Benjamin Franklin said when referencing fighting fires: “an ounce of prevention is worth a pound of cure."

 

Tools like iClickCare can support a Managed Care system by improving the way that coordination and collaboration happen. See how iClickCare can work for your organization with a free 2-week trial:

Try the iClickCare 14-day evaluation

Tags: coordinated care, accountable care, managed care, capitated care

Is There a Shortcut to Care Coordination Cost Savings?

Posted by Lawrence Kerr on Mon, Feb 09, 2015 @ 08:30 AM

vegetablegarden

I live in a beautiful rural area, which is great -- unless you are trying to grow a vegetable garden.

It seems like the country would be perfect for vegetables, but I've found that when gardening where I live, wildlife becomes a daily battle, with deer seizing upon produce with the stealthy precision of Navy SEALs. I had always seen more proficient gardeners with pro-built custom fencing solutions and felt that I obviously couldn't choose one of those. I could build that myself! It's just a little fencing and I could see what they were trying to achieve with each component. Plus, the all-in-one solution cost $600.

Anyone that's ever tried a home improvement project knows where this story is headed: $540 of materials, nine days of work, and three trips to Home Depot later, I had tried to replicate the all-in-one solution, cut myself with the fencing, had to return all the materials, and eventually just bought the all-in-one solution.

Now, the DIY version is not always worse. I make bread and cheese at home, and my wife sews. But usually the cobbled-together solution is better when you don't care as much about the outcome as the process. For instance, when you include the books, materials, and resources that I've bought to make my homemade bread, it certainly doesn't come out cheaper than the stuff from the bakery. But I love the process, so it makes sense to do.

Every day, we're under increasing pressure to cut costs while improving outcomes: more and more is demanded, with fewer and fewer resources. In that context, many people have come to us looking for ways to save money on care coordination tools, platforms, and protocols. You know that you really need an efficient solution to prevent readmission and manage care of your patients, but you don't want to waste resources.


So when is an all-in-one system worth it? And when does it make sense to create your own care coordination system?

 

These are some of the common functions that Accountable Care Organizations and managed care organizations tell us they need in a care coordination platform (whether telemedicine or not):

  • Make your information technology network very secure and impenetrable from the outside. Be sure that files on the network cannot be seen by everyone.
  • Find a way to prevent transmission of pictures or taking of pictures. (We have found this to be a frequent answer, and while secure, does little to coordinate care.)
  • Use a checklist so that nothing gets dropped.
  • Enable both provider-to-provider communication as well as patient-to-provider communication.
  • Send secure messages between providers
  • Archive unique cases for teaching to medical students and residents.
  • Create a patient portal so they can understand the course of treatment and engage in options.
  • Integrate with EMRs and EHRs
  • Manage admissions and discharge.

These are all functions that can be handmade, homemade, or patched together using existing tools. So when hospital systems and managed care organizations come to us to ask, we always tell them the same thing: if you're excited about the process of piecing together your own care coordination / medical collaboration / telemedicine system, then go for it! But if you're looking for the most efficient and effective outcome,  you may be better off with the pro-built system (iClickCare is one option) that has it all included already. Just as I would have been with the vegetable garden fencing. 

 

If you've been doing cost comparisons of telemedicine systems for care coordination, maybe our guide to one all-in-one system can help:

 

ClickCare Quick Guide to Hybrid Store-and-Forward

 

 

 

Image courtesy of hardworkinghippy on Flickr, used under Creative Commons rights.

Tags: telemedicine, medical collaboration, accountable care, care coordination, ACO, managed care

Nurses Risk HIPAA Violations With BYOD Texting

Posted by Lawrence Kerr on Fri, May 30, 2014 @ 08:23 AM

pager resized 600

In many sectors, pagers are a technology that came and went with the '80s and '90s. With the advent of cellular phones, and then smartphones, the simple alarm-plus-message functionality became obsolete quickly.

In medicine, however, pagers are still ubiquitous. Most hospitals and medical settings use pagers as their main form of communication, primarily because they are viewed as low-risk communication tools. However, despite pagers being the more common choice, they're not necessarily the better choice. Pagers cost US hospitals $8.3 billion in 2013: $3.2 billion through lengthy discharge processes and $5.1 billion while clinicians wait for patient information.

The evidence shows that we may be reaching a crisis point regarding the viability of using pagers in medicine:

  • With so many providers at different parts of the continuum of care, and with so many handoffs within a given case, pagers can't keep up with care coordination.
  • In an age of increasing malpractice suits, having no record of communications or responses is riskier than ever. 
  • With pay-for-performance, rather than pay-for-service, being today's touchstone, it is no longer sustainable to be wasting time or money with an antiquated technology.

As usual, it is the providers themselves -- particularly the nurses -- who are taking matters into their own hands and finding efficient ways to communicate whether regulations or administrations support them in doing so. Hospitals are seeing a de facto Bring Your Own Device (BYOD) situation and 67% report nurses are using their smartphones to support clinical communications and workflow. According to research by Logicalis, the phenomenon is even more common in high-growth markets (like Brazil and India): almost 75% of users in these countries used their own devices at work, compared to 44% in places like the US. 

Why can't pagers support medical collaboration and coordination of care like smartphones can? Benjamin Kanter, chief medical informatics officer at Palomar Health, explains:

"The message is only one piece of the puzzle. You've got to provide context and you've got to be able to create action. Most secure texting systems don't take that into account."

When medical providers come to us for advice on how to coordinate care and collaborate without running afoul of hospital regulations or HIPAA, we acknowledge that it can be tricky. That's why we recommend the following: 

  1. Don't ignore HIPAA. While we do applaud the persistence of medical providers who just "get the job done" and use their own smartphones as necessary, we caution our colleagues to not use text messaging, email, or their regular camera roll as none of these are HIPAA-secure. The penalties are too great to risk it. 
  2. Be willing to go first. Sometimes a provider will be ready to use iClickCare for medical collaboration but hesitate because their institution doesn't already use it (even if it's allowed). If we're going to change medicine, we have to be willing to lead the charge -- first an individuals, and then as a community. 
  3. Be realistic about the complexity of your communication.  Popular messaging services don't incorporate the use of photos, videos, archiving, and consults with any provider. Communicating is great, and a great start, but the reality is that our medical collaboration demands more than a text message to really accomplish the communication and coordination we need. 

For our rundown of telemedicine options, pros, and cons, click here:

ClickCare Quick Guide to Telemedicine

 

Image courtesy of hades2k on Flickr, used under Creative Commons rights.

Tags: iPhone, medical collaboration software, coordinated care, medical collaboration, HIPAA, accountable care, iPad medical apps

7 Ways Telemedicine Helps Compliance with Accountable Care

Posted by Lawrence Kerr on Wed, Feb 26, 2014 @ 08:52 AM

hospital bracelet resized 600

 

Barely a day has gone by recently, that the Affordable Care Act (ACA), Accountable Care Organizations (ACO), or the Centers for Medicare & Medicaid Services (CMS) have not been in the news.

In the broadest strokes, the Accountable Care movement attempts to shift the health payment system from a pay-for-service (fee based) system, to a pay-for-performance (outcomes based) system. Of course, for hospitals that want to accept Medicare and Medicaid, these reforms are mandated. But the overall approach affects almost all practices, regardless of status or whether you are an ACO.

Part of the reason that these policies aren't going anywhere is that early data shows they're working. In 2012, ACOs established in the Medicare's Shared Savings Program generated nearly $400 million in savings, the Centers for Medicare & Medicaid Services said in a statement released last week. 

Despite the laws, it's not always clear how to use telemedicine to improve outcomes in a pay-for-performance system. Interestingly, telemedicine and telehealth has been identified as a key tool in compliance with Accountable Care. It is even written into CMS' final rule for the Medicare Shared Savings Program: accountable care organizations must "define processes to promote evidence-based medicine and patient engagement, report on quality and cost measures, and coordinate care, such as through the use of telehealth, remote patient monitoring, and other such enabling technologies.

So here are 7 ways telemedicine can help you comply with Accountable Care: 

  1. Telemedicine makes care coordination possible and effective. Just changing incentives is not enough to improve outcomes. As the New England Journal of Medicine reports, "Merely aligning financial incentives will not improve quality and reduce costs for episodes of care... True coordination of care is required to ensure the best possible outcomes." Telemedicine makes this kind of care coordination possible and effective, particularly in a hybrid store-and-forward context that adapts to provider parameters.
  2. Telemedicine makes transportation less necessary. Whether home monitoring or distance consults, telemedicine can save costs of unnecessary visits and lengthy transportation. When payment is linked to outcomes, even saving a patient or provider a single trip can make a big difference over an organization.
  3. Telemedicine leverages provider time. In an age of provider shortages, telemedicine can make each provider's minutes count as much as possible. Through consults, collaboration, and even remote patient visits, provider time is leveraged. 
  4. Telemedicine can decrease readmissions. Because telemedicine can help the right at-home care to happen, clarify which provider is responsible, and make sure patients follow through, telemedicine has been shown to have a strong effect on decreasing readmissions.
  5. Telemedicine can drop length of stay. Data shows that care coordination, especially the kind of collaboration supported by telemedicine, is one of the strongest ways to drop length of stay. And length of stay is a key outcome in Accountable Care.
  6. Telemedicine improves access to care. Telemedicine can improve access for the underserved in rural, urban, or Veteran populations. Especially as provider shortages worsen in different parts of the country, and for different specialities, this kind of access to care is proving crucial in keeping costs down and meeting patient needs.
  7. Telemedicine supports good patient care, regardless of political climate and payment changes. Truth be told, many of our colleagues have been using telemedicine to improve the ways they care for patients -- regardless of whether it's rewarded by the current political context. We think that's good practice, in every election cycle.

 

Click here for our free guide on the pros, cons, and ROI of telemedicine options:

 

ClickCare Quick Guide to Telemedicine

 

 

Image courtesy of chelseastirlen on flickr.com, used under Creative Commons rights.


Tags: collaboration, coordinated care, accountable care, ACO, telemedicine roi, telemedicine solutions, communication with patients, decrease readmissions, decrease length of stay, affordable care act

Care Coordination Saves Careers -- Learnings from the Super Bowl

Posted by Lawrence Kerr on Tue, Feb 04, 2014 @ 08:50 AM

percyharvin resized 600

 

After Percy Harvin's father left, his Mom started a daycare out of the home to make ends meet. Percy, always wanting to contribute to his family, would help with the little ones when he got out of school.

Percy wasn't just conscientious or a hard worker, though: Percy had a spark. His athletic talent grew through his high school and college years. And then, he won the sports lottery -- Percy was drafted to the NFL.

After his rookie year, things changed. Percy suffered a string of illnesses and injuries that made him miss game after game. Finally, just last year, Percy was traded to the Seahawks. A new franchise that had never won a Super Bowl, the team's motto was "why not us." Unfortunately, though, Percy was suffering from serious injuries. Over the course of the '13-'14 season, he only played a couple of minutes.

As Percy navigated hip surgery, inflammation, pain, and finally a concussion, the Seahawks made their way steadily toward the Super Bowl. Just 10 days before the big game, Percy was still on the injured list.

Percy's doctors, physical therapists, and other providers were obviously doing effective care coordination, though, because suddenly, just 7 days before the Super Bowl, Percy was cleared for play. Once Percy made it onto the field, he mage a significant contribution. His kick-off runback seemed to break the spirit of the Denver Broncos, eventually leading to his new team and beaming coach winning their first-ever championship.

Had Percy's recovery taken just a week longer, he would have missed the Super Bowl and maybe led to a loss -- an event potentially hugely damaging to his career. Those seven days of speedier recovery, likely due to care coordination and thoughtful medical care, were profoundly valuable to Percy, his team, and his family. When we save patients days, weeks, or months of injury and sickness -- whether the issue is cancer, hip issues, colitis, or congestive heart failure -- we don't always see the benefits so starkly. But Percy Harvin's story shows that care coordination with telemedicine not only saves lives -- it can save careers, whether you're an NFL player, a mom, or a mid-level manager.

So the next time you're wondering whether care coordination could help your patient, even if you don't have a system in place, ask yourself, "why not us?" And give coordination, collaboration, and telemedicine a shot. It will definitely contribute to a life, and might even save a career.

 

Get our guide to medical collaboration and care coordination here:

ClickCare Quick Guide to Medical Collaboration

 

 

Image courtesy of ifindkarma on flickr.com, used under Creative Commons rights. Percy Harvin's story and facts from his wikipedia page

Tags: mhealth, telemedicine, coordinated care, accountable care, telemedicine solutions, hybrid store and forward medical collaboration, decrease readmissions

4 Tricks for Getting Reimbursed for Telemedicine

Posted by Lawrence Kerr on Fri, Jan 31, 2014 @ 07:49 AM

 

piggybank resized 600

Many people have been hearing telemedicine success stories and want to start using using technology to collaborate and connect with providers and patients.

Most folks use telemedicine to improve patient care and maybe make their lives as providers a little easier. However, those motives don't get around the fact that we all need to be paid for the work we do.

Reimbursement for telemedicine is a crucial part of making the practice sustainable. But it's not always easy to know how to make that possible when the political climate and reimbursement policies are constantly changing.

So here are 4 tips and resources to make sure you're paid for telemedicine:

  1. Just do it and worry about reimbursement later. Many of our colleagues have found that when they put collaboration and patient care first, the reimbursement ends up taking care of itself. So pay attention to reimbursement -- but if in doubt, just go ahead and care for the patient or collaborate with telemedicine and let the details sort themselves out later.
  2. Use the right codes. We've assembled a list of codes you can use to bill for telemedicine-related time. This is always changing, but keeping an eye on the right codes increases reimbursement significantly.
  3. Make sure you're billing for everything you can. Many providers don't know that in addition to patient-related time with telemedicine, you can also bill for time spent collaborating, and even charge a remote site facility fee. 
  4. Be smart about pre-authorizations. Always check if the patient’s insurance company needs a prior authorization. If so, text the pre-authorization information and patient insurance plan to the consultant.

 

Need guidance on telemedicine options? Get our guide for free:

ClickCare Quick Guide to Telemedicine

 

 

Image courtesy of 68751915@N05 on flickr.com, used under Creative Commons rights.

Tags: collaboration, iPhone medical apps, telemedicine law, accountable care, telemedicine roi, compliance

Can Telemedicine Lower the Cost of Healthcare?

Posted by Lawrence Kerr on Thu, Jan 23, 2014 @ 08:14 AM

hospitalbill resized 600

Telemedicine is thriving these days -- there is even an ad on prime-time featuring it -- and a key reason are the ways telemedicine lowers the cost of healthcare. One indicator of this is the political support: "Telehealth is a major contributing factor to increased health care quality, convenience, and lower costs," said Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio). And there is certainly anecdotal evidence from around the country, like this tele-dermatology program in Nantucket saving nearly $29,000 a year.

In fact, we've found that the people and organizations that use iClickCare experience such significant and immediate cost savings that we've even incorporated an ROI calculator on our website. Dr Michael Moore, director of a wound care program, reported that "During a 3 month period, 70 patients were treated solely using iClickCare with an overall healing rate of 93% and an estimated savings of $24,000 in transportation costs alone."

Of course, despite its clear potential and proof points, telemedicine doesn't always cut costs. It's important to look at projects like this one for lessons from the front lines about what really works, and what doesn't.

So if you're considering a telemedicine program in your hospital, practice, or region... 

5 things to keep in mind to ensure telemedicine lowers the cost of healthcare:

  1. As we shared in this post, you are not setting yourself up for success if you make huge investments in hardware. We recommend investing in software (which can be updated, and is generally the lowest portion of costs) rather than hardware which gets obsolete quickly. Use the equipment you already have, the spaces already available to you, and just start. 
  2. Give special attention to readmissions and length of stay. Readmissions within a month of discharge cost $16 billion per year. And as we all know, readmissions and length of stay are big parts of the ACA shared outcomes focus. So we're interested in data showing that medical collaboration may be one of the strongest ways to decrease length of stay... and in this Connected Cardiac Care program, which has achieved a 51% decrease in readmissions with telehealth monitoring.
  3. Prioritize rural areas or very urban areas. Geographically removed areas (whether rural or inner-city) find the most cost-cutting benefits from telemedicine. "By decreasing the importance of location for healthcare provision, telemedicine can help increase competition and further lower healthcare spending for primary care and specialist consultations... using technology to allow health care workers to quickly serve those where there is the greatest demand will create a more efficient health care system overall," says Ben Miller of the WFS.
  4. Use your people effectively. Because of the provider shortage, the leveling of access helps cut costs and use our provider workforce most efficiently. As Dr. Brian Rosenfeld, Chief Medical Officer at Philips Healthcare, said, "Telehealth offers the opportunity to provide the access, quality and cost that will be necessary to increase prevention and leverage our current workforce."
  5. Work in coordination with the Affordable Care Act. Telemedicine may prove to be the linchpin in controlling costs and outcomes as the Affordable Care Act comes into being more broadly, according to Mario Gutierrez, executive director for the Center for Connected Health Policy.

Overall, we've seen over and over again the cost savings that can be experienced through telemedicine. But we do suggest keeping it simple, start small, and start today.

For an overview of choices in telemedicine, download the Quick Guide to Telemedicine

ClickCare Quick Guide to Telemedicine

 

 

Image courtesy of seeminglee on flickr.com, used under Creative Commons rights. 


Tags: telemedicine, accountable care, telemedicine roi, telemedicine solutions, decrease readmissions, decrease length of stay, affordable care act

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