ROI in telemedicine and telehealth? Outlook unclear.

ATA 2013’s final ‘industry executive session’, presented at the late hour when most attendees are daydreaming about a comfy chair and a solid drink, tackled one of the thornier underlying questions beleaguering health tech: return on investment (ROI). Providers want hard numbers, but even that definition is…indefinite. Is it data? Is it outcomes? Is it savings? Is it reduction in spending? For two systems or populations, it can be reducing 30-day same cause readmissions for one provider or improved outcomes in home care for another, and the results are not analogous nor even cause-and-effect. As Eric Wicklund from mHIMSS put it, “that’s the challenge, and it was the primary focus of this year’s ATA conference. The pilots are gone, the possibilities and proposals are old. It’s time to target the telemedicine and mHealth programs that are working and to explain why they are…” As GlobalMed’s Roger Downey less delicately put it, “It’s like pinning Jell-O to a wall”–but getting specific as to what should be done in the market helps. Not quite as blithe as the headline. ROI? To some of the industry’s top vendors, that’s just three letters.

Of course, EHR implementation continues to be the Rodney Dangerfield of health tech, with HITECH Act ‘Meaningful Use’ interoperability goals and patient platforms only spottily achieved despite years of generous past, present and future incentive payments. Yet one ATA presenter seriously advocated the addition of telehealth/telemedicine to MU standards, recommended that Health and Human Services become the authority and to add panels for Federal standards and policy in telemedicine as there are for health IT. Adding telehealth and telemedicine to the MU scramble will surely speed implementation ;-) (See above) Why not MU for telemedicine? (HealthcareITNews)

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  1. Is RoI the only yardstick for investing in new technology? I don’t think so. Sometimes you have to invest in enhancing the customer (patient) experience just because it’s what they want.

    Healthcare often has too many variables to make financial RoI calculations meaningful.

    Providers should focus instead on:
    a) making sure the mobile health service is what the customers (patients) want, and;
    b) working with vendors to reduce the capex required to launch mobile health services to a level where the “RoI” can be measured by uptake rather than how much money is made/saved.

  2. Challenging. I heard similar comments from conference. ROI has long been elusive in healthcare; well in fairness, sometimes… grin. Most business strategies require ROI. Some business strategy decisions fall partially under the “the cost of doing business” header. Questions asked are: what is the outcome, how will we be affected if we do not do this, what is the risk; you walk through a risk benefits analysis exercise. In healthcare IT you have to look at where you want to be in the bigger picture. Even though things are moving fast, some things are clear. In healthcare today you have to have collect, manage, analyse, and exchange data to play.

    If you can envision where healthcare is going you can make informed, forward thinking business decisions. Isn’t it amazing though that just today it was announced that Obama is mandating that all government “systems must be built on open standards to facilitate data sharing”. We will get there; anyway you look at it healthcare is changing, its moving forward.