Commentary

How Telemedicine Is Propelling Change Around The Hospital Experience

Telemedicine will no doubt increase patient engagement, because patients who receive care when and where they want are more motivated to participate in self-care. And on the provider side, being able to identify what is important to the patient and providing those services will go a long way to establishing a partnership outside of the office visit. From reviewing medical records to charting treatment plans, from reading x-rays to home healthcare, telemedicine is making healthcare more available to everyone. 

One area where telemedicine and enhanced patient engagement has the potential to make a real difference is around hospital visits. One clear change that will be evident with telemedicine uptake is reduction in ER visits, and therefore proactive health management. Our health system now asks patients to get in the car, find parking at the hospital and wait for hours (possibly) to see a physician, while all this could potentially be replaced by a telemedicine session. My guess is that people will seek medical advice sooner, perhaps mitigating the issue and therefore the long term implications of delayed treatment. For patients that come to a hospital or healthcare facility for a procedure, when they are discharged, they may end up being readmitted within a month if they don’t have a plan in place for ongoing care and long-term support. 

In the UK, a 2011 study reported that telehealth produced:

  • 20% reduction in ER admissions
  • 15% reduction in ER visits
  • 14% reduction in elective admissions
  • 45% reduction in mortality for patients with chronic conditions

By providing tools for ongoing care, telemedicine can connect patients, physicians, and nurses after discharge, and ensure that patients don’t lose touch with their care team and the important information that is key to ongoing success. When a patient is leaving the hospital after treatment, they are not in optimal shape to digest all of the information that is being given to them by their doctor and discharge team. Even when a caregiver is present, they too are focusing on other aspects of hospital discharge like logistics, emotions, safety, home care, etc. Patient engagement is best delivered in bite-sized chunks, and unfolds like chapters of a story according to a cadence dictated by the procedure or treatment regimen for a patient. For example, if a patient has just had a hip replacement, the information they need most in the first few days is likely to be around pain management and monitoring of symptoms, whereas after the first week, the information should be centered on physical therapy and rehabilitation. 

This parsing out of information is possible via telemedicine because it offers not only real time chats with a health care professional, remote monitoring, medication and appointment reminders, but also ongoing patient education. Ideally the patient engagement strategy will be specifically “prescribed” by the physician and is tailored to procedure, date of procedure and patient type.

Aside from ER visits and post discharge follow up, another important piece for telemedicine as it relates to hospitals is regarding healthcare for people in rural areas that don’t have access to urban centers with top notch physicians and technology. According to Dr. R. Pande, chief medical officer at Abilto and a cardiologist at Brigham and Women’s Hospital, about one-third of the telemedicine participants come from rural areas. “These are individuals who would probably never get the type of care we deliver – a combination of behavioral, coaching, and therapy delivered to high-risk medical populations.”

As this fascinating capability unfolds, we must apply tried and true patient engagement strategies to this new method of care delivery. Albeit there are challenges to full adoption, including cost, regulation, and healthcare provider fears about quality of care and technology adoption – however if we consider the outcome benefits and the ways in which we can take patient engagement up a notch, it seems like a win-win all around.

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