It’s Time Telehealth Grows Up and Transforms Healthcare

By Jim Prendergast, CEO and Founder of Clever Health

Coming out of the acute phase of the pandemic, telehealth continues to grow at an accelerated rate across the nation. Telehealth promises to connect patients to the right resources at the right time and in the right place. Virtual care benefits have been well known since before Covid-19 and include reducing long wait times, lowering healthcare costs, making care more accessible to all (at all times) and eliminating many unnecessary high-cost visits to urgent care and the emergency department. But is today’s “telehealth” really innovative and making good on the promises to reduce costs and improve access and outcomes? With high per employee per month (PEPMs), a misaligned physician network and little innovation beyond call routing and facetime, today’s mainstream telehealth falls short in reducing actual healthcare spend, increasing clinical efficacy or improving the overall health of our nation.  However, there is hope for more — much more.  By marrying already existing tech in digital health, telehealth and healthcare AI, we can expect our next virtual care platform to not only treat acute ailments even more quickly and efficiently but to also help prevent illness, identify trends, provide complex care, manage health risks by reducing drug interactions, identify and close gaps in care for the chronically ill, integrate with our health records, claims history and insurance plan and coordinate the exact care needed based on personal history, symptoms, co-pays/deductibles, time of day and patient preference.  

Cost

Today’s use of telehealth is little more than a convenience offered in many health plans. The pandemic created massive awareness and adoption for both patients and physicians. However, the cost of a telehealth visit is, in most cases, is higher than an in-person visit.  Various studies show the average telehealth consultation cost to be more than $200 per visit. This is the result of a combination of using “physicians for hire” who are not aligned with outcomes, poor adoption of technology and high (and unnecessary) PEPMs built into health plans. By adopting and integrating advances in technology in communication, AI decision support, interoperability and cloud storage, we can drive down the costs per visit by at least 90% and perhaps even make it free.  We can do this while providing a better experience for both the patient and the physician, increasing clinical efficacy and improving the overall health of all patients.  

Innovation

Developments in AI decision support technology have made it possible for physicians to receive an AI diagnosis and recommended treatment plan in just a few minutes after a patient logs on, requiring the physician to spend less than a minute to confirm the diagnoses and connect with the patient. Adding asynchronous communication options only enhances the experience and decreases time to treatment for all parties.  With the advancement in AI, smart phone biometrics and real-time access to personal health records, tomorrow’s virtual care can assist in making a more accurate diagnosis, flag potential health issues previously unreported, check for potential drug contra-indications, find the lowest prescription prices, whether in plan or out and even tell a patient if they are on the right health plan. Utilizing AI helps physicians treat more patients while maintaining, and in many cases improving, outcomes. By lowering the time a physician spends per visit, physicians charge less per visit. For local physicians, studies show that providing virtual care to local organizations for low or even no cost, can be their most effective patient acquisition and retention tool, making low or no-cost telehealth a win for all. 

It’s not a stretch to say that when done correctly, the right virtual care platform can provide a physician with the most personalized comprehensive look into a patient’s health, both past and present.  When coupled with massive amounts of population health data and driven by AI, we can not only treat a sore throat or pink eye, but now we can identify, in real time, if the condition is something more serious leading to faster diagnosis and earlier treatment.  Not only will this save both time and expense to the patient and health plan, but it could save a life! 

Utilizing the Data

Today’s telehealth is very much a benefit that sits in a silo seemingly outside the health plan. With a few exceptions like claim integration, the self-reported symptoms, diagnosis and treatment plan are rarely shared with all stakeholders. Primary care providers, care coordinators, pharmacists and insurance providers can all help to improve health and outcomes when accurate information is reported in a timely manner. The last frontier of telehealth is the complete, real-time integration of all data gathered not only during the virtual visit but from all other recent claims, new prescriptions or self-reported health information. This can and should be happening now but there remains millions of telehealth consults where data is not shared. Providing all care providers with up-to-date data in real time is paramount to optimizing health, managing patient risk and reducing health care expense.  

It’s time to throw away the term “telehealth” in favor of much smarter solutions integrated with digital health strategies. For decades we have blamed the healthcare system for legacy architecture and poor sharing of information. Most of those problems can now be solved making interoperability the norm and changing telehealth into a vital part of seeking and managing care. The technology to turn telehealth platforms into highly intelligent, personalized, comprehensive and efficient digital front doors to all your medical needs is already available. It’s time we demand more out of “telehealth.”

About the author

Jim Prendergast is the former founder and CEO of Healthiest You and current founder and CEO of Clever Health, a smart virtual care leader. Clever Health is penetrating the industry in record time. Launched in August 2021, the company has grown from 30,000 to almost two million contracted lives. Services include smart virtual care, concierge medical providers, integrated prescription savings and mental health support that are faster, better and more affordable. The app is available for download in the Apple Store and Google Play. For more information, visit https://www.cleverhealth.ai/