1. The Skinny on Telehealth Business Planning
Amelia Bischoff, Manager Telehealth, Palmetto Health
Christianna Novakovic, Telehealth Program Coordinator, Greenville Health System
Michelle Hager, Managing Partner, Blue Cirrus Consulting

2. Conflict of Interest Michelle Hager
Worked with Greenville Health System and Palmetto Health System to create their business plan and strategy for telehealth. No other conflicts of interest or disclosures to report.

3. Telehealth Strategy Development Palmetto Health & Greenville Health

4. Confronting Barriers to Change
Cultural Resistance
Service Delivery Silos
Scarce Resources
Protection Instinct
Financial
Comfort with the past/ known
Historical delivery model
ED and inpatient financial engines
Providers, management & staff
Reimbursement
models
Threat
(vs. opportunity)
Amelia
Decision-making
and Leadership
Time

5. Cultural Resistance The Problem The Solution
Technology solution variation
Overloaded providers
Health system versus consumer preferences
Fragmented or absent telehealth strategy
Standardize platforms internally and externally
Joy at Work –cultural impact
Provide educational services and administrative support
Consumer needs and preferences lead growth
Strategic alignment across the enterprise –driven by leadership

6. Service Delivery Silos
Programs embedded into service lines without system-wide coordination and management
Business plan development and support structure created
New medical group brought together clinicians, academics and leaders
Reimagining virtual care, capitalizing strengths, and aligning priorities
Amelia

7. Protection Instinct: Reimbursement Model Fee-for-Service
Developer
takes product
to physician
and generates
interest
Payer approached for coverage
Service covered and FFS payment secured
Service and coverage taken to health system finance
Investment approved and funding secured
New product or service line incorporated into clinical workflow
Christianna

8. Changing Incentives
Christianna
Move away from fee-for-service towards shared risk and population health

9. Movement Toward Value-Based
Value based, manage care contracts developed with payer
Capitation, bundled, or shared savings contract secured
Clinicians
observe
opportunity
for telehealth
to make
processes
more efficient
Investment approved and funding secured
Developers or vendors sought for needed technology
Christianna

10. Application & Tools
Michelle

11. Telehealth Market – The Growth
Industry is expanding at an exponential rate:
Anticipated $197 Billion in net savings over
next 25 years to US healthcare systems
From 250,000 Patients served in 2012
to an estimated 3.2 Million by 2018
worldwide
North America accounts for 40% of
global market – Largest market
Recent 2016 projection indicates the
global telehealth market is expected to
reach $1 Billion by 2017 (Accenture)
2020
$34.27 Billion
2018
$2 Billion
2015
$428.6 Million
2012
$240 Million
Global Market Value
IHS: World Market for Telehealth – 2014 Edition
Morder Intelligence (Global Telemedicine Market – Growth, Trends & Forecasts ( ) Aug 2015
Accenture 2016

12. Reimbursement Challenges
“The results of a survey conducted by Anthem and the American Academy of Family Physicians' Robert Graham Center revealed 9 out of 10 physicians would use telehealth, if they were properly reimbursed.”
(HITN 2015)
Image Reference: National Conference of State Legislatures January 2016

13. The Telehealth Value Proposition
Accessibility: care when and where you need it
Affordability: reduces travel time/expense and time away from work.
Timeliness: reduces wait times to access care.
Coordinated and Integrated care.
Patients 1
Promotes coordinated care.
Maintains primary relationship with the patient.
Maintains credibility with the patient.
Promotes greater patient satisfaction.
Generates revenue and visit reimbursement.
Providers 2
Keeps patients local.
Promotes rapid diagnosis and treatment linked to improved outcomes.
Improved outcomes improve the health of the population.
Community 3

14. Workflow Patient Criteria Clinical Workflow Selection
Sustainable Solution
Patient Criteria
Selection
Clinical Workflow
Interoperability
Technical Workflow
Future/Present
State

15. Needs Assessment

16. Cost/Benefit Analysis

17. Prioritization

18. Decision Model

19. Contact Information
Amelia Bischoff, MHA
Manager, Telehealth
Clinical Informatics
Office:
Christianna Novakovic, MHA, CAPM
Telehealth Program Coordinator
Greenville Health System | Clinical Integration
(864)
Michelle Hager
Managing Partner
Blue Cirrus Consulting
@bcirrus