Debunking all the Reasons for Not Using Telehealth Aditi Joshi MD, MSc, FACEP Medical Director, JeffConnect Assistant Professor Department of Emergency Medicine Thomas Jefferson University Hospital aditi.joshi@jefferson.edu Twitter: @draditijoshi

Objectives Introduction Background of Telehealth and Our Experience Common Myths Debunking the Common Myths Overcoming the Barriers

WHO Definition of Health Technology "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives." Medical technology, or medtech, encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies (applications of medical science) are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and reductions in hospital stays and rehabilitation times.[3] Recent advances in medical technology have also focused on cost reduction. Medical technology may broadly include medical devices, information technology, biotech, and healthcare services.

Digital Health Convergence of digital and genomic technologies to enhance healthcare delivery. Includes: Devices Telemedicine/Telehealth Applications Sensors Home monitoring VR/AR AI Digital health is the convergence of digital and genomic technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and make medicines more personalized and precise.[1] The discipline involves the use of information and communication technologies to help address the health problems and challenges faced by patients.[1] These technologies include both hardware and software solutions and services, including telemedicine, web-based analysis, email, mobile phones and applications, text messages, and clinic or remote monitoring sensors.[2][3] Generally, digital health is concerned about the development of interconnected health systems to improve the use of computational technologies, smart devices, computational analysis techniques and communication media to aid healthcare professionals and patients manage illnesses and health risks, as well as promote health and wellbeing.[1][3]

JeffConnect Jefferson’s Telehealth program Name of our telemedicine platform Scheduled calls OnDemand calls for acute urgent care Created with Teladoc platform and honed for the specific needs of a healthcare institution and its patients

JeffConnect’s Enhancement of the Medical Home © 2015 Jefferson

Potential Telemedicine & Urgent Care Programs Engage family members who are not present Virtual rounds model Hybrid models of care Central telehealth hub Post discharge care Engage specialists Virtual Urgent Care Convenience Reduced travel Enhanced Care Coordination All Video Visits All Jefferson Physicians 24/7/365

Programmatic Development Senior leadership Leadership – Jeff is top-down Business/strategic plan development Goals (unmet need) of patient population Scope of program Approach Understanding external forces Legal & regulatory Reimbursement Consumer trends Internal forces Prioritizing Opportunities

Common Myths: Provider Version Patients don’t want to do it Provider uptake is a challenge Reimbursement is difficult and not going to change soon The Tech is too difficult/unreliable You can’t do a proper physical exam It’s not as good as an in-person visit

Myth One: Patients don’t want to do it

On-Demand Care: Results for JeffConnect Survey results Net Promoter Score > 70 Health complaint addressed as hoped > 90% Time saved over one hour = 87% Already recommended JeffConnect = 81% Initially patients didn’t care if provider was Jefferson or not; we are now seeing a slight change in response 40% of visits new patients 83% would have sought care elsewhere 45% in ED or urgent care center 74% received no further care Most sent to ED required admission or procedure These results are in-line with other larger studies such as done by Salesforce

Myth 2: Providers uptake is a challenge

Changing Providers minds is a herculean task… You already ‘do’ Telemedicine We all want what is best for patients It can lead to more efficient care

Myth 3: Reimbursement is not going to change soon

New laws and policies are already showing promise of change Medicare bill passed 2/2018 Different states have had early adoption and about half have parity laws Cost savings Waiting for this to change will ensure being left behind

Myth 4: Technology is difficult and unreliable

Hasn’t stopped us from using it in other spheres There are plans for expanding WiFi to lower income areas Tech improves daily and reliable staff/experts can be employed

Myth 5: You can’t do a proper History and Physical Exam

History becomes important – listening to our patients You can do quite a lot by Telemedicine exam by being creative Always have the ability for higher level of care Future trends suggest this will be less and less of an issue

Myth 6: It’s not as good as in-person visit

The other option might be delayed or no visit How do we define health and healthcare? The future is going to be home-based care What we think of medical visits will change

Overcoming These Barriers Education Marketing Research

Final Thoughts I challenge everyone to rethink how they think Healthcare has to be practiced. All trends point to more technological innovation. These myths and barriers shouldn’t hold you back. Don’t get left behind!

Thank you Aditi.joshi@Jefferson.edu @draditijoshi