Knowledge Expansion Leveraging direct-to-consumer telehealth to improve provider productivity Insight Article Patient Care Technology Sign in to save Clinton Phillips The perfect storm is brewing: the looming physician shortage, provider burnout and an aging population may combine to create a future in which access to timely healthcare is threatened — unless the healthcare industry takes steps to enhance provider productivity. The United States could see a shortage of up to 122,000 physicians by 2032, according to a 2019 report1 from the Association of American Medical Colleges (AAMC). To some extent, the physician shortage is a result of the feelings of burnout and fatigue that are pushing some physicians out of medicine. According to the AMA,2 despite improvements in the past three years, burnout levels remain much higher among physicians than other U.S. workers. Meanwhile, the U.S. population is growing and aging. By 2030, 71 million Americans will be age 65 and older.3 These factors have combined to help accelerate physician adoption of telehealth, which increased nearly 1,400% between 2014 and 2018 for provider-to-patient, non-hospital-based telehealth.4 Factors to consider Telemedicine is poised to fundamentally change the way medical care is provided, enabling physicians to more productively deliver care, in practices of every size. But before rushing to implement a telemedicine solution, it’s important to consider patient satisfaction and cost. Patient satisfaction Telehealth has great potential to strengthen the patient-provider relationship when used correctly. Unfortunately, many patients are most familiar with a direct-to-consumer (DTC) telehealth platform that requires patients to use the vendor’s provider network. Patients can’t be seen by their physicians and are forced to consult with someone who is unfamiliar with their medical history. They are randomly assigned to a provider they have never met. If they use the service again, they’re connected to yet another unfamiliar clinician. Patients naturally prefer telehealth solutions that allow them to be seen by physicians they have built relationships with, using technology they are familiar with, such as their smartphones. Cost Telehealth solutions do not necessarily require investing thousands of dollars. Some leading platforms don’t even require upfront purchasing or leasing of hardware. For a flat monthly fee, physicians can provide telehealth consults via a mobile app. Leading smartphone apps offer full, HIPAA-compliant security for messaging, audio and video consultations, group chats and language translation. Regardless of the technology, the goal of patient-provider communication is to create a stronger human connection that ultimately leads to better health outcomes. A provider’s experience with telehealth By Chris Montoya, MBA-HCA, MPAS, PA-C, president and owner, TPC Family Medicine and Urgent Care and TPC Family Medicine and Home Visits, email@example.com. I started my medical group practice, San Antonio-based TPC Family Medicine and Urgent Care Clinic in 2011, after 20 years of service in the U.S. Army. As a physician assistant in the Army, I served several tours in Iraq in an infantry battalion delivering care to and fighting alongside my fellow soldiers, and also earned two Bronze Stars and a Purple Heart. When I founded TPC after returning home, I sought to bring the focus, discipline and task-oriented nature I developed in the military to the practice of family medicine in Southwest Texas. In the military, we’ve used telemedicine for decades to deliver fast and convenient care in hospitals and in the field, so adding the capability to my practice was a natural fit. A few years after opening TPC, I adopted a mobile communication platform for providers and patients that enables me to communicate with patients via text message and requires no technology hardware investment beyond the smartphone in my pocket. I believe that if we help more physicians adopt telemedicine, it could go a long way toward relieving the persistent problems our healthcare system has experienced with access, cost and patient satisfaction. How telehealth improves communication and productivity In my experience, the primary benefit of telehealth from the patients’ perspective is being able to obtain care on demand. That in itself is a luxury when contrasted with the typical routine that requires patients to conform their schedules to the providers’, arrange for transportation to the office and sit for an indeterminate amount of time in the waiting room. Among telehealth’s greatest advantages is the diversity of options that allow me to communicate with my patients either synchronously (in real-time) or asynchronously. These options include video conferencing, audio conferencing, text messaging, e-mail and photographs. Texting, in particular, represents my patients’ top choice for conducting virtual visits due to its widespread popularity and the ubiquity of mobile devices, especially among younger patients. Texting (via a secure, HIPAA-compliant messaging app) enables me to connect with patients in a manner they find comfortable and familiar. For routine visits, such as cough and cold, ear infections or prescription refills, telemedicine enables me to quickly and conveniently deliver needed care, while saving office visits for more time-consuming and complex cases such as patients with chronic hypertension or uncontrolled diabetes. Typically, I see about 40 patients per day, a pace I could not sustain if I wasn’t visiting with about a quarter of them via telemedicine. In this regard, telemedicine enables me to deliver more care in less time, boosting my productivity, reducing burnout and increasing my accessibility to patients. With greater convenience and efficiency in care delivered on patients’ terms, patient satisfaction rises and the provider-patient relationship is strengthened. As a result of telehealth, a doctor-patient relationship no longer has to be established and enhanced only through face-to-face interaction. Notes: “The complexities of physician supply and demand: Projections from 2017 to 2032.” IHS Markit Ltd. Prepared for Association of American Medical Colleges. April 2019. Available from: bit.ly/2MXBu13. Berg S. “New survey shows decline in physician burnout.” American Medical Association. Feb. 21, 2019. Available from: bit.ly/2Mzz89N. “What do we mean by health and aging policy?” Health and Aging Policy Fellows. Available from: bit.ly/2J96xpw. Gelburd R. “Use of non-hospital-based provider-to-patient telehealth grew nearly 1400% from 2014 to 2018, FAIR Health finds.” AJMC. July 22, 2019. Available from: bit.ly/35UFhF6.