Telemedicine: we build it, they came, now what?

ABSTRACT

The COVID19 pandemic brought telemedicine from pilot project to mainstream practice in the matter of a fewweeks. The natural progression to move from a well-researched clinical trial to a self-supported clinicalenterprise has proven to be perilous for most programs. This talk will review the steps required to successfullyjump this chasm and point out the unexpected pitfalls along the way. Capturing and sustaining some benefitsafter the COVID19 pandemic will require practices to reflect, recognize and quantify the value thattelemedicine can bring to their patients and families. Rightsizing your program is the key to achieving financialsustainability and being able to offset the fixed costs of your equipment, connectivity and telepresenters. Withnew accountable care reimbursement plans, using telemedicine to help your organization achieve pay forperformance measures may be more lucrative than the traditional fee for service models. Quality of carestandards recommend routine health maintenance visits every three months for children with a variety ofchronic conditions including asthma, attention deficit hyperactivity disorder, diabetes and obesity. Many urbanprimary care practices experience a no-show rate of close to 50% for these health supervision visits. Barriersto access, competing demands for parents' and students' time, and financial constraints are all cited as reasons for this poor adherence rate. Direct to patient telemedicine within the patient centered medical homemay offer solutions to most of these issues as long as service can be safely and conveniently brought to thechild either at home or at school.