According to the Kaiser Family Foundation report of 2015 employer-sponsored health insurance covers over half of the non-elderly US population, for a total of 147 million people. A report published by the Institute for Healthcare Consumerism suggests that health care costs use up to 50% or more of a company’s corporate profits. Of these, the indirect costs of poor health that include absence of work and decreased productivity can be up to 2 to 3 times the amount spent on direct medical costs. As companies become more engaged in their need to decrease costs associated with providing healthcare to their employees, emerging telemedicine platforms are rapidly evolving as a potential vital tool to control costs, improve access to care, and reduce absenteeism.
By engaging telemedicine enabled care, employees avoid the disruption of having to take time off to receive care for conditions which can be generally managed via remote access. Telemedicine services can take several forms: real-time video or telephonic communication including text interaction between patient and physician, remote monitoring of patients such as those with chronic illnesses, medication adherence tools, and other remote web and mobile applications to assist with management.
Telemedicine is certainly at the forefront of medicine, but several issues must be addressed and process redesign in the creation of new delivery care models including those in the workplace must take center stage:
- The declining number of primary care physicians as well as increasing wait times for physician visits and the demand for same day visits are helping drive telemedicine and telehealth to the forefront of innovative solutions to offset these problems. However, fragmentation of care continues to be a concern especially for consumers frequently using alternative sources of care other than their primary care physicians. Additionally, telehealth services pose a significant threat to disruption in the continuity of care for patients, especially those with chronic conditions such as diabetes.
- Contracting directly with vendors such as Teladoc, MDLive or Doctor On-Demand permits corporate entities to establish preferential pricing solutions to help offset costs of providing care. Telehealth providers generally employ either proprietary or private Electronic Health Records (EHR’s) in the process of providing care. The patient data incorporated and integrated into the health record remains with the vendor’s EHR. It is important to understand how the employee have easy access to their medical history as well as have the tele-visit encounter transferred to their primary care physician. What will happen to data access if the vendor goes out of business? How are requests for the information gathered during the telehealth encounter dealt with by the vendor? Who owns the data of the encounter and what safeguards are in place to protect patient/employee confidentiality and monitor HIPAA privacy compliance? Undoubtedly, telehealth vendors like all providers have a need to not only obtain data, but also analyze, track, and interpret data to help achieve the performance goals.
- Furthermore, what safeguards are in place in the event of misdiagnosis or delay of treatment? Are the vendors of telehealth services solely at risk or are employers also at risk in the event of malpractice litigation?
- Accessing a provider through a web or mobile service may not be the preferred option for every employee population. How does the vendor plan to communicate the service, increase adoption, and drive engagement
Telemedicine offers a solution for employees to obtain care in the workplace and at home without disruption of normal activities. While telehealth can expand the reach of medicine and potentially reduce the cost of certain services for many, it is still an unstructured field with many different approaches to care.
Article written by: Mario Moya MD
Mario Moya MD is a native of Del Rio, Texas and has been in private practice in the Philadelphia area since 1995. He currently works providing vascular services in the outpatient setting in multiple states and holds unrestricted licenses in 21 states. Dr. Moya earned his undergraduate degree at the University of Texas at Austin and subsequently pursued his medical studies at the University of Nuevo Leon in Monterrey, Mexico on a scholarship program. He completed Surgical and Internal Medicine Internships as well as Radiology Residency at Mercy Catholic in 1994 followed by a Fellowship in Vascular and Interventional at MD Anderson Cancer Center in Houston Texas. Committed to lifelong learning, he is currently enrolled as a student in Brown University’s Executive Master of Healthcare Leadership. Dr. Moya became interested in population health management and the use of telemedicine as an adjunct in the proactive management of chronic conditions such as Diabetes. As a physician, he is passionate about being at the forefront of new models of care that employ evolving virtual technologies with true medical home care services providing greater access to care for management of chronic conditions in underserved areas.