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By Monica E. Oss

Since our recent OPEN MINDS Technology & Informatics Institute, I’ve been thinking—will the coming year bring us the “telehealth tipping point?” The “tipping point” is, by definition, a critical point in a situation beyond which a significant and often unstoppable change takes place. Malcolm Gladwell, the new father of the “tipping point” concept (see The Tipping Point Reading Guide), wrote that “All kinds of high-tech products fail, never making it beyond the Early Adopters, because companies fail to transform an idea that makes perfect sense to an Early Adopter to one that makes perfect sense to a member of the Early Majority.”

Deciding how close we are to the tipping point means deciding how to measure it. I see four factors pushing the strategic impact of telehealth in the field and pushing us closer to that tipping point.

Greater adoption of telehealth by health plans—Recent research shows that 96% of all health plans use telemental health services, including 41% of all health plans that use eCBT, 21% that use an online engagement tool, and 16% that use consumer-facing portals. And 50% of Medicaid health plans have adopted these technologies (see Trends In Behavioral Health: A Reference Guide On The U.S. Behavioral Health Financing & Delivery System). Employer health plans are also seeing big adoption rates, as 96% are expected to make telehealth available in states where it is allowed, including behavioral health services (56%) (see Employer Health Plans Pushing Telehealth Adoption One Step Closer To ‘Ubiquity’).

Changes in policy from the Centers for Medicare & Medicaid Services (CMS)—In October, CMS issued a proposed rule to give Medicare Advantage plans in 2020 more flexibility to offer telehealth benefits to all members and improve coordination for dual eligible beneficiaries. While Medicare would continue geographic restrictions on telehealth in the fee-for-service program, Medicare Advantage plans would be able to offer telehealth benefits to all enrollees, not only those in rural areas (see Medicare Proposes Additional Telehealth Benefits For Medicare Advantage Plans).

Expansion of telehealth services at the U.S. Department of Veterans Affairs (VA)—We have seen major moves to expand access to telehealth for veterans with the passage of the Veterans E-Health and Telemedicine Support Act of 2017 and new policies from the Veteran’s Administration (VA) (see VA Finalizes Telehealth Rule Allowing Health Care Professionals To Practice Across State Lines; Senate Passes VETS Act, Enhancing Telehealth Access for Veterans and House Passes Bill Expanding VA Telehealth Across State Lines). Additionally the Department of Defense (DoD) also released updates to TRICARE coverage, requiring telehealth to be covered in the same way it covers in-person visits (see Major Changes Coming To DoD’s TRICARE System Jan. 1). And on March 6, 2018, the VA announced it launched a pilot telehealth program to provide rural veterans with post-traumatic stress disorder (PTSD) remote access to psychotherapy and related services (see VA Launches Pilot Telemedicine Program For Rural Veterans With PTSD).

New data on the effectiveness of telehealth—New research continues to show the effectiveness of this tech. In just the last couple months, we’ve see that remote telemedicine autism evaluations diagnosed children nearly as accurately as in-person assessment (see Autism Evaluations Conducted Via Telemedicine Nearly As Accurately As In-Person Assessment); teleconsultation programs can reduce wait times by two-to-six months for young children at highest risk for autism (see ECHO Autism Teleconsultation Program Reduced Wait Times Up To Six Months For Highest-Risk, Rural Children); and that virtual education delivered to consumers with chronic conditions was comparable, or more effective, than normal care (see The Efficacy Of Telehealth Delivered Educational Approaches For Patients With Chronic Diseases: A Systematic Review). And last month at The 2018 OPEN MINDS Consumer Engagement Technologies Summit, Roberta Montemayor, Director for Telehealth of Optum Behavioral Health also shared information about Optum’s new Virtual Visits program, which includes over 4,700 clinical professionals offering telemental health services (see Virtual Visits: An Overview Of Telemental Health Services From Optum). Optum reports that virtual care can provide 20% faster appointments than in-person sessions and may result in a 60% decrease in missed appointments; as well as a 25% reduction in hospitalization rate and lengths of stay. Ms. Montemayor noted, “We know the members who use this has a 25% reduction in services. The effectiveness is as least as good as in person, and often better because members can get their care sooner.”

Even if 2019 is not the year, I suspect the tipping point is nearing. Now is the time for executive teams to look at how wider adoption of telehealth could affect organizational competitive edge and sustainability. For more on how virtual health is raising the fundamental sustainability of therapy and of primary care, see What Will Mental Health Treatment Look Like In The Years Ahead?, The Primary Care Reinvention, and Workforce Problems? Technology As Strategy. And for executive teams that want to optimize virtual health technologies, be sure to check out these resources from the OPEN MINDS Industry Library:

  1. Using Virtual Care To Improve Your Value Proposition: Best Practices In Integrating Technology Into Your Community-Based Program
  2. Anticipating The Strategic Impact Of Virtual Health
  3. Selecting Digital Technologies: The Vinfen Approach
  4. A Virtual Health Update
  5. The Telehealth Market – Now, Soon & Future
  6. The Telehealth Market – The Future Has Arrived
  7. Primary Care Goes Virtual & On-Demand
  8. The Latest Telehealth Example: Pay-For-Value
  9. The Uphill Climb To Virtual Care
  10. Yes, There Are Organizations Using Augmented Intelligence

For more on the strategy it will take to find, assess and adopt telehealth, join Senior Associate Joseph P. Naughton-Travers on February 13, 2019 in Clearwater Beach, Florida for his 2019 OPEN MINDS Performance Management Institute executive seminar, “Making The Right Tech Investments For Your Organization: An Executive Seminar On Technology Budgeting & Planning.”

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