ATA2017 dispatch: Catalyzing telehealth innovation in hospitals

Bruce Judson, our guest ATA 2017/Telehealth 2.0 reporter, is a bestselling author of books on business and technology issues in the evolving digital era. This is the second article this week from the ATA floor. Mr. Judson writes frequently for The Huffington Post. More on about him may be found in our review of his critique of the RAND telehealth study [25 Mar]. His discussion with ATA’s Jonathan Linkous on business models for telehealth is here.

Orlando, April 25. At the ATA show, I stopped at Mercy’s booth, and spoke with Keela Davis, who is Mercy’s Executive Director, Innovation and Product Development. In the booth, was a large, inspirational display of Mercy Virtual’s high-tech, widely-reported $54 millionhospital without beds.” The facility is the nerve center for Mercy Virtual’s telemedicine programs, which include TeleICU (remote monitoring of ICUs by Mercy specialists) as well as multiple other remote services for patients in hospitals and at home.

A great deal has been written about Mercy’s groundbreaking service and large investment in this facility. I asked Davis what led to the decision to build “the hospital without beds.” She said that first, a lot of experience in telehealth proceeded the investment decision. Undoubtedly this experience was required to simply decide what should be built in a facility designed for the technology that exists today and that will undoubtedly accommodate new technologies as they arise. Second, she also said, that it reflected “a visionary” decision on the part of Mercy’s leadership to make this commitment. Now, in her words, the facility has become “a symbol of our work.”

As a student of innovation, our discussion was notable on several fronts:

First, Davis noted that now that the facility exists it serves as a catalyst for innovation. Mercy is actively considering, as might be expected, a range of new telehealth services. While Davis was quick to point out that the facility was not the only source of telehealth innovation at Mercy, she did indicate it’s the hub for innovative ideas and discussions. Organizations build on their experience, their successes, and the demonstrated commitment of management to move forward with good ideas. Mercy’s facility now provides the tangible place that facilitates ongoing growth. In short, after conquering the first level of innovation, Mercy is poised to march forward with new, groundbreaking services.

Mercy’s facility is also a warning to organizations that see the telehealth future, but hesitate to act. As Mercy gains experience, it will have a team that understands the many, complex aspects of assessing and bringing new services to market. Plus, many of the underlying capital and investment requirements associated with creating these services have already happened. In short, it will soon be difficult for other healthcare entities eyeing services in the same arenas to match Mercy’s innovation machine.

Home telehealth now focused on the ‘superusers’ of healthcare

A noticeable trend in telehealth has to do with focusing less on the generic virtues of at-home vital signs monitoring for routine patient care and more on managing specific high-cost populations to avoid or reduce costs. Some of the impetus in the US has come from new regulations by CMS (Center for Medicare and Medicaid Services) intended to move Medicare fee-for-service (FFS) patients into a reimbursed chronic care management (CCM) model. Banner Health is Arizona’s largest private employer (which does say something about Arizona as a retirement haven) and since 2006 has been experimenting with remote monitoring since 2006. Starting in 2013 Banner piloted Philips‘ post-discharge program now called ‘Hospital to Home’ as Banner iCare, combined with Philips Lifeline PERS, but made it available to those only with a stunning five+ chronic conditions–the top 5 percent that is reputed to account for 50 percent of healthcare spend. Banner combined the tech with intense support by a multi-layered care team. At ATA they announced the following results with the initial cohort of 135 patients, now up to 500:

  • 27% reduction in cost of care
  • 32% reduction in acute and long term care costs
  • 45% reduction in hospitalizations

The article in Forbes is a bit breathless in profiling the program and the ‘superusers’ of healthcare (with a windy but false analogy from John Sculley) but provides a level of detail in the program that most articles do not. One wonders how Philips makes money on supplying what is at least $2,500 worth of kit, with peripherals that must all be Bluetooth LE. It’s also not stated, but the TeleICU and TeleAcute programs also appear to be Philips’. Video