Telehealth: Bringing The Doctor to The Patient in A World of Social Distancing

According to the American Telemedicine Association, the term “Telehealth” includes a wide range of valuable services, all of which are more relevant today than they were a month ago.

Telehealth Categories

 

What was previously referred to as “Telemedicine” now encompasses a much broader array of categories, including the following:

Store-and-Forward

Sometimes called “Asynchronous Telehealth,” store-and-forward solutions enable healthcare providers to forward and share patient medical data (ie, lab results, images, videos, records) with a provider at a different location. This is a way to share private patient data online in a secure way. 

Remote Patient Monitoring

Including home Telehealth, uses devices to remotely collect and send data to a home health agency or a remote diagnostic testing facility (RDTF) for interpretation. Such applications might include a specific vital sign, such as blood glucose or heart ECG or a variety of indicators for homebound consumers. Such services can be used to supplement the use of visiting nurses.

Real-time Telehealth

Also called “Synchronous Telehealth”, this is probably what most people think of first when they hear the word “Telehealth.” Real-time Telehealth requires a live interaction between either a health professional and patient, or between multiple health professionals, using audio and video communication.

As Telehealth technology has matured over the last decade, it has become more and more prevalent. According to an AMA survey, the number of HCPs using Telehealth has doubled since 2016. The AHA states that 76% of U.S. hospitals connect with patients and consulting practitioners using video and other technology, and a study performed by NGBH revealed that virtually all (96%) of the nation’s large employers provided medical coverage for Telehealth in 2019. HCPs and health systems are interested in adopting Telehealth since it will reduce costs, increase access to rural areas, and efficiently organize the flow of care. 

However, one obstacle to adoption has been patient perception. According to a 2019 JD power survey, 48.7% believe the quality of care is lower than that of a doctor’s office visit, with only 6.2% perceiving the quality to be higher. Furthermore, 49.1% see Telehealth as “no more or less personal” with only 8% reporting the visit as “more personal.”

Of the 8% of consumers who have used Teleheath, here is the breakdown of where they are located.

Confusion around coordination with provider coverage is also a barrier; 74.3% of consumers believe their health system or insurance provider does not offer Telehealth coverage. Patients’ perceptions around coverage confusion is no surprise since Telemedicine parity laws have only been passed in 29 states. (Telemedicine parity law means private payers in that state have to reimburse for Telehealth care in the same way they would for in-person care.) 

However, once patients move past these perception issues and they experienceTelehealth firsthand, they are generally pleasantly surprised. According to a Harvard review, 97% of patients are satisfied with their first Telehealth experience and would recommend the program.

The majority of Real-Time Telehealth usage growth has been happening in urgent care centers, retail clinics, and ambulatory surgical centers, but we now expect to see rapid growth across all practice sizes and configurations.

Telehealth willingness and usage by demographic

How COVID-19 Has Changed the Telehealth Landscape

 

COVID-19 has completely changed most people’s lives, and the rise of Telehealth should be no surprise in these times. The current perception barriers will begin to shift as more people are exposed to Telehealth as the safest option in the current climate. 

We have seen increased use in Telehealth:

Up 50%

                                     Daily virtual medical visits in past week

~ 100,000

              Virtual medical visits to patients in the united states in the past week

15,000

                                              Visits requested per day

More Patients

                   More of those patients are experiencing upper respiratory issue

The government has also shown they are willing to help push this behavior change through; HHS recently stated that Telehealth services will be covered for millions more. Medicare beneficiaries, and providers will be allowed to offer these Telehealth benefits to Medicare beneficiaries at a lower cost than traditional services.

To accelerate this movement, the American Telemedicine Association is hard at work building a case to pass parity laws in all 50 states, even as states themselves start taking measures to reduce cross-state licensing restrictions. Even quarantined doctors are using Telehealth to continue to see patients remotely while they, the doctors, are in quarantine. 

At FCB Health, we just fielded research with a range of HCPs, and as of 4/2, 90% of doctors have reported that they have or plan to transition their practice to telehealth and they are encouraging their patients to reach out if they can’t wait for regular office hours. We will monitor how this trend continues when the COVID-19 distancing rules are no longer needed.

 

Types of Telehealth Solutions

 

Two types of Telehealth paradigms have emerged to support patients.

Health-System-Controlled

For HCP relationship-driven disease management (think chronic or ongoing care). Health systems and payers have created their own infrastructures or partnered with a technology solution like Amwell, eVisit or Teladoc to use their own doctors and white-label the technology. A few good examples are:

 

These Telehealth infrastructures provide another vehicle for HCPs to treat patients virtually without the need for in-person visits. The AHA states that 80% emergency virtual visits wind up “resolving the episode of care” without a trip to the emergency department or another site of care. This not only reduces strain on the physical offices, but also reduces providers and patient cost burdens.

Opportunity: Just as reps are allowed to detail HCPs in office. Large Telehealth providers (ie, Amwell Health, Teladoc) are setting up virtual detail capabilities to allow brands to reach their Telehealth HCP partners. 

Online-Platform-Enabled, Doctor Relationship Agnostic

These are online platforms that have a set of virtual doctors online 24/7. They can be general or disease state specific but mostly used for acute care treatment. Some include:

Largest Providers Covered Under Most Plans

 

Disesae State Specific

 

Opportunity: Online platforms allow for direct integration from a brand’s ecosystem. Integration can range from just a CTA on a brand.com to a fully-branded triage survey. The level of brand integration can be customized to a brand’s need and budget.

 

Types of Brand Partnerships and Examples
 

As pharma tries to leverage the upswing in Telehealth, we will need to be cognizant of how specific disease states are being treated in the Telehealth channel. This will help decide whether we can connect into an already established behavior, or if we will need to build confidence in the Telehealth treatment paradigm as well.

Here are a few different ways brands have integrated with Real-Time Telehealth programs:

Chantix (Sets up Telehealth visit, connected through disease state information):

  • Links from Chantix.com to product-agnostic Telehealth website
  • Limited brand integration with Telehealth provider
  • Source: Chantix

Qbrexza (Brand integration): 

  • Integration of patient information into brand.com 
  • Disease state specific Telehealth provider
  • Source: Qbrexza

Imvexxy (Sets up Telehealth visit, connected through disease state information):

  • Links from Imvexxy.com to product-agnostic Telehealth website
  • Source: Imvexxy

Hello Rory—Latisse (Integrates the product into an existing ecosystem)

  • Specialty pharmacy model
  • Integration of brand into Telehealth/pharmacy promotional model
  • Source: Helly Rory

One Size Does Not Fit All

 

In this new age of social distancing, Telehealth can be an effective tool to drive more HCP/patient conversations. That said, Telehealth isn’t right for every brand and we need to be thoughtful around our recommendations of how heavily it’s integrated into a brand’s promotional ecosystem. 

As teams start to customize Telehealth to their brand needs and budgets, here is a starting place to begin the discussion with your clients:

Is a Telehealth Solution Right for your Brand or Disease State?

Does diagnosis require in-office testing? If “yes,” then a Telehealth virtual visit might not lead to a diagnosis and may be seen as a waste of time and money for a patient. If “no,” then what type of HCP/Patient relationship is needed to begin treatment? Most Telehealth platforms provide patients with a new doctor they have never seen. This may reduce the level of trust in the HCP’s recommendation and may not be suitable for some treatment options.

What Will Your Specific Team Be Able to Do?

Some MLR teams confuse Telehealth integration with paying doctors or platforms to prescribe product. This will impact how directly you can send a patient to a Telehealth experience from your branded property. If you have a more conservative team, the Chantix and Imvexxy options outlined above may be more suitable. Other teams may opt for a more direct connection between the brand experience and the Telehealth platform.

Based On the Above, What Partnership Is Right for Your Brand Budget?

Telehealth programs are customizable to your brand’s budget, but as with any sponsored partnership program a greater investment level is required as the level of integration increases, particularly with market leaders in Telehealth.

 

Please contact your account leads or ross.quinn@fcb.com if you have any questions or would like to discuss any of the above.