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Texas eHealth Alliance Visits Zipnosis

On August 30, leadership from the Texas eHealth Alliance (TeHA) visited Zipnosis as part of their strategy to grow relationships with members and better understand the technology that’s being used in healthcare today. The meeting included a product demonstration, discussion of how Texas telemedicine policy has impacted Zipnosis customers, and TeHA’s continued focus on ensuring Texas is leading the charge in healthcare innovation.

Zipnosis has a long history with TeHA. Dr. Rebecca Hafner-Fogarty, Zipnosis’ founding chief medical officer and current senior vice president of policy and strategy serves on the board. The two organizations partnered closely to help guide Texas’ well-publicized telemedicine bill (SB 1107) that was signed into law in May of 2017.

“Our close relationship with Zipnosis made this visit particularly valuable,” said Nora Belcher, executive director for TeHA. “We were excited to meet the people behind the technology and continue discussions about how we can advocate for digital health policy that facilitates innovation while maintaining the rigorous patient protections that are so important.”

Dr. Hafner-Fogarty echoed that sentiment, stating, “It is truly an honor to work with TeHA. They are one of the foremost digital health advocacy organizations in the country. We appreciate their partnership and thoughtful approach to making Texas a leader in innovative healthcare delivery.”

Zipnosis’ work with TeHA is part of their larger regulatory focus, helping to ensure health system customers in Texas and across the country are able to launch virtual care in a way that follows the letter and spirit of the law.

Virtual Care in a Trump America: Making Care Great Again

So, there was this election last November. You might remember it or you might be trying to forget, but either way a new president was sworn in January 20th. Ever since the results were tallied, I’ve been inundated with a barrage of predictions for what the new administration means for the healthcare industry – in particular, for virtual care and telemedicine.

The one thing everyone can agree on is that with Trump in the White House, healthcare policy is going to change. So, what place does virtual care have in a Trump America?

No One Really Knows the Future

OK, it might seem kind of counterintuitive to say that after I just wrote about my forecasts for virtual care in 2017, but bear with me. Speculation about how lawmakers at the federal level approach healthcare policy can be well founded. It can be based on campaign promises (we all know how those go), party politics and previous voting records. But, our democracy is complex and unpredictable. And despite speaking Russian, I have no real insight into the policy direction the Trump administration will take with regards to healthcare.

Here’s What I do Know

While I can’t tell you precisely what legislative changes will come with the new Congress and President, I can tell you that there are macro-level trends in the healthcare industry that will continue to influence digital healthcare, telemedicine and virtual care, regardless of who’s in office. (Tweet)

And that’s where I can effectively make predictions. Like tiny snowballs starting downhill, the following trends have become avalanches in the healthcare mountainscape. Their momentum – more than federal policy – will be the major influencers of virtual care over the next several years.

The Transition to Value-Based Care Will Continue to Gain Momentum

Value-based reimbursement is here, and it’s here to stay. You can check out my post on Becker’s Hospital Review for a primer on value-based care and its impact on virtual care. Suffice to say, virtual care offers health systems a real means to cope with the changes the shift to value-based payment is producing.

Right now, value-based care is still gaining traction, but a number of factors make this shift inevitable. For one, healthcare costs are continuing to rise. Value-based reimbursement can help curtail those costs while supporting high quality care. A recently published study in JAMA found that using bundled payments for joint replacement decreased Medicare costs between 13% and 21% and produced fewer readmissions, emergency visits and prolonged hospital stays.

With insurers seeking to improve the bottom line and the move to high deductible health plans (HDHPs) and health savings accounts (HSAs) leaving patients paying more out-of-pocket, the transition to value-based care is only going forward.

Predicted Primary Care Physician Shortages and Patient Access Remain Challenges

Back in 2013, the Health Resources and Services Administration predicted a primary care physician shortage of more than 20,000 by 2020. Just this past year, the American Association of Medical Colleges issued a report projecting a shortfall of between 14,900 and 35,600 PCPs. This report went further and noted that if all barriers to care were removed, the U.S. would need an additional 96,000 doctors to meet patient needs – today.

All signs point to the population expanding relative to the number physicians available, meaning that improving patient access to care is only going to be more important going forward. I anticipate virtual care – with its increased clinical efficiency – is going to be a critical piece to solving these challenges.

Patient Demand for Virtual Care isn’t Going Anywhere

In our infographic, Virtual Care by the Numbers, we outline how patient demand for virtual care is impacting the industry. Some of the highlights include 76% of patients rating access over in-person care, and 62% of patients stating they’d be willing to replace an in-person visit with an online visit.

This demand is only going to increase as technology becomes more embedded in people’s lives.

People are Increasingly Spending Their Time Online

So, show of hands: Who has a Facebook account? Twitter? LinkedIn? Instagram? How about Netflix or Hulu? The world is more digital than it was even a few years ago. We shop, access entertainment, and even build and maintain our friendships and business relationships online. According to the Pew Research Center, 38% of all adults’ primary news sources are online – a number that goes up to 50% between the ages of 18 and 49.

This shift to a virtual world is only going to grow as more and more resources are available via digital channels. And, this holds true for healthcare, as well.

Virtual Care’s Place Going Forward

These trends may have started as a tiny shift in the snow cover, but they’re full-blown, unstoppable avalanches now. While I can’t predict policy, I feel confident that moving forward, virtual care has an important role in helping health systems and patients deliver and receive care as the landscape changes.

A Step in the Right Direction – New AMA Policies Will Benefit Virtual Care Telemedicine

The virtual care and telemedicine industry is evolving quickly. Over the past several years, we’ve seen major shifts in how care is delivered, increased adoption by both health systems and healthcare consumers, and a number of new companies entering the market. And these shifts are just the beginning. It’s vital we remain focused on how to manage what is coming next – because it’s coming quickly.

At their most recent meeting, the American Medical Association (AMA) addressed the telemedicine industry with new ethical guidance on telehealth and telemedicine, recommendations for including telemedicine training in medical school and residency programs, and a promise to advocate for parity laws that require insurance to cover telemedicine and virtual care services.

We believe these guidelines are a step in the right direction, and offer a jumping-off point for moving virtual care telemedicine forward.

Ethical Guidance

These guidelines are aimed at bringing consistency in quality care delivery to virtual care. As noted in our recent industry call to action, there are some serious issues facing our industry – not the least, a huge gap in quality reporting standards.

Key elements of the AMA’s ethical guidance included informing patients  of the limitations of services provided, advising them on how to arrange follow-up care, and encouraging them to inform their primary care doctor when they engage with a telemedicine provider.

What does this mean? Well for one, physicians can leverage the AMA’s guidance to help them determine whether a diagnostic evaluation and prescribing therapy through telemedicine technology is viable and appropriate. It also provides a clear set of industry standards that can help health systems effectively evaluate vendors as they seek to launch a virtual care service. A definite step in the right direction.

Training

Health systems count on undergraduate and graduate schools, as well as residency programs, to ensure new clinicians have the tools and skills necessary to care for patients. Increasingly, this means use of technology, including virtual care and telemedicine solutions. It is a very welcome development that the AMA is now calling  for greater incorporation of technology training in these programs. With greater knowledge and understanding of virtual care, new clinicians will be well positioned to help health systems take the necessary steps to meet patients’ evolving needs.

Insurance Parity

Lack of reimbursement for virtual care and telemedicine services is often listed as one of the prime barriers to greater adoption. We’ve been advocating for parity for years as we seek to help our clients offer virtual care telemedicine to their patients. While more than half of states have laws requiring insurers to reimburse telemedicine-delivered services, the reimbursement landscape is still disjointed.

The AMA’s promise to advocate for insurance parity can help even the playing field and bring greater consistency to reimbursement from state to state. In support of insurance parity, the AMA said it would develop model legislation to achieve parity at the state level and work with state medical boards to draft model state legislation defining telemedicine for inclusion in state-level medical practice laws and regulations.

Going Forward

Virtual care and telemedicine continue to be the future of healthcare delivery. This forward-thinking gives our industry the guidance it needs now, and the long-term support to continue our current trajectory.

From bringing consistency and standardization to quality of care in the telemedicine industry, to giving the next generation of clinicians the tools they need to effectively navigate virtual care, to leveling the playing field to enhance access to virtual care and telemedicine services. We applaud the steps taken by the AMA, and are excited to be part of building the future of the virtual care industry using the foundation they’ve provided. And we hope our industry peers and the AMA will join us in leveraging evidence-based policy in this process.