It’s a rare feat to be engaged, educated, and entertained at the same time, but the Oxford-style debate at Connected Health on telehealth’s effectiveness did all three. Moderated by new Chief Digital Officer for Partners Healthcare, Alistair Erskine, MD, with Ateev Mehrotra, MD debating that telehealth is not effective, and head of the American Telemedicine Association, Andrew Watson, MD debating that it is, the format and discussion delivered a provocative closing session on Day 1 of Connected Health. As decided by the audience, the winner was Dr. Watson, citing effective programs like telestroke, consults and expert referrals, and rural medicine. However, applause for Dr. Mehrotra was also strong, and I suspect that his major points that telehealth has not reached broad adoption, and in fact there have been observations that telehealth is actually increasing utilization as people follow a telehealth visit with an in-person visit. The question is whether that visit wouldn’t have happened and we’d see worse health outcomes, or whether the person had a problem that couldn’t be helped with telehealth.
— Wellpepper (@Wellpepper) October 18, 2018
In another deep dive session on telehealth, “Making Connected Health Work for Physicians”, Kevin Fickenscher, MD talked about a unique program to train clinicians on virtual visits. Given that the diagnostic capabilities are different, for example, you can’t touch the patient, this makes perfect sense. Questioning and listening skills are going to be more important than physical exam, and observation may be limited by (current) video technology. Also in this session, Ami Blatt MD from Partners, talked about how her young and mobile patients essentially lead her to telemedicine, by insisting that was how they wanted to communicate: the consumerization of healthcare in action. She also recommended to any physicians wanting to deploy a telemedicine solution to make sure that the goals of the program align with the financial incentives available for the hospital.
So, what do we take away from this? Twenty years later, telemedicine is still in the promise stage. Practice and reimbursement needs to change even more to find true breakthroughs, and perhaps we should look at pattern matching to find other successful workflows and outcomes that resemble the benefits for telestroke.
In no particular order, here are some other observations from the conference:
- Patients are taking a bigger role, whether that was a patient co-presenting in a session on Patient Generated Health data, the Wego Health Awards honoring LupusLady as an activated and collaborative patient, or the society for Participatory Medicine pre-day with patients included, the voice of patients is increasingly being listened to with a real seat at the table.
- Digital therapeutics and behavioral health are hot. There was a special pavilion on the tradeshow floor dedicated to digital therapeutics where our fellow Seattle health innovators, 2Morrow presented great results from their smoking cessation programs.
- Patient-generated data is starting to show promise and much greater acceptance by clinicians, particularly in the ability for clinicians and patients to talk to each other. However, we’d still like to see a better connection of data and actionable care plans, and there was still some mention of the data being better because patients cheat when verbally relating data like blood sugar after the fact. Data alone isn’t enough to support patients or change behavior, and it shouldn’t be continued punitive.
Doctors talk doctor and I talk patient. We used the data to move the conversation from monologue to dialogue #connect2health
— Wellpepper (@Wellpepper) October 18, 2018
From Session: PGHD End User Experience: Patients and Providers
- There’s a continual blurring of the lines with engagement, particularly member and patient engagement, and there were a ton of new companies in this space (again), all offering to get members and patients engaged. From their overviews it was hard to tell how targeting providers and payers was even different aside from the terminology.
- Although a full-day devoted to voice interfaces definitely showed it’s a hot topic, AI was definitely the buzzword of the show.
We’re already gearing up for HIMSS 2019 where we hope the buzzword of the show will be “outcomes”. We just heard that our talk on the (really positive) results of the REACH study has been accepted. See you there?