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By Monica E. Oss

We kicked off last week’s 2014 OPEN MINDS Technology & Informatics Institute with a look at where we’re at with telehealth. The pre-institute seminar, Using Telehealth To Reduce Costs & Add Revenue: A Guide for Provider Organization Executive Teams, was led by my colleague Robert N. Cuyler, Ph.D., and focused on identifying the developments in telehealth, and building a sustainable program based on that information.

bob_cuylerBob’s opening question? Are we near the “tipping point” in the widespread adoption of telehealth – or will telehealth in the U.S. continue to be a slow and inconsistent service technology that has been unevenly adopted?  We have covered this issue before – Where Are We With Telehealth? Does The Snapshot Tell The Story? – but Bob provided some interesting context for the discussion of adoption and timing. According to the recent HIMSS Analytics telemedicine survey; 46% of health system respondents currently offer telemedicine; 67% of the rest were investigating telemedicine; 40% are using it to fill gaps in patient care; and 23% use it to offer care not otherwise available. The widely used telemedicine technologies are by far three very common technologies – two-way video (57.8%), image sharing technology (55.5%), and email (44.1%).


To answer this question of timing and how best to develop your own telehealth model, Bob pulled together a great panel of subject matter experts, including Chris Jaquis, Strategic Accounts Director, Breakthrough Behavioral; Elizabeth C. Kwo, M.D., MBA, Vice President, Network Operations, American Well; Scott Baker, New Markets Developer, InSight Telepsychiatry; and Jim Mountain, President, Secure Telehealth. A few of their great insights are outlined below.

Mr. Jaquis led off the day with a discussion of the complexities that underlie telehealth – or more to the point, how many people underestimate the complexity of a system that is a lot more than “two talking heads.” The layers that every organization needs to keep in mind include an easy to use system and tools, a trained and dedicated staff, a strategic partner that can help you maintain the scale necessary, and the legal and regulatory expertise to maintain compliance. Mr. Jaquis described this system as “a sustainable practice with engaged patients, paying for itself in one way or another, and find new patients, over and over again.”

Dr. Kwo took another look at the complexities of the system from the standpoint of, who can solve all the baseline issues that function behind the scenes to make a telehealth experience a seamless, ready access, successful system? The key to answer this question is to figure out what you do best, and then figure out the partnerships you need to put in place to build the foundation. “A lot of people assume it’s really easy to get people on the system, and to get providers on board,” said Dr. Kwo, “But there really are a lot of things going on behind the scenes.”

Mr. Baker’s assessment that “providers need to stand up and decide what is ‘good telehealth’, and what isn’t” pointed to the possible mixed blessing of telehealth. Depending on what technology organizations adopt, that tech can either promote continuity of care, or promote fragmentation. How? The market place will probably offer a whole spectrum of tech choices, driven a lot by consumer choice which may aggravate fragmentation problems. An example would be an in-home model that can open the door for unintended interruptions (e.g. doorbells, barking dogs, consumer risks). As Bob noted, “I don’t want to talk to a client who is in a Starbucks, or on a floaty in a pool and drinking a mojito.”

Mr. Mountain ended the morning with the summation that organizations looking to adopt this technology will just need to wade through all the choices to find the ones that meet the necessary business need. “It’s amazing that we have so many choices,” Mr. Mountain said. “There are four companies here today and we hardly compete because there are so many options.”

So how do you create a sustainable telehealth environment? Put another way, what would you do in the most basic community theatre before the curtain goes up? It’s a very complex answer before you go live. For more about technology, stay tuned in the coming week for our post-institute coverage of The 2014 OPEN MINDS Technology & Informatics Institute; and check out our archived coverage on Twitter @openmindscircle #TII14, and on Facebook at


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