How Should CEOs Evaluate New Service Lines for Telemedicine?

TeleNeurology as a Model for Telemedicine Growth—Part 2

Many hospitals have established a successful telemedicine model with teleNeurology and teleStroke. The next logical step is to add additional specialties to expand access to care. But, which ones? How should CEOs evaluate new service lines for telemedicine?

It starts with a holistic view of the care needs of the communities you serve and the resources you have to deliver that care. Hospitals are no longer stand-alone businesses but integrated networks that include physician groups, post-acute services, hospice care, and other care providers. It can be daunting to try to align services among the entire ecosystem.

Begin with the end in mind

In The 7 Habits of Highly Effective People, Steven Covey advises us to “Begin with the end in mind.” In order to build a successful new service line for telemedicine, you must first understand the outcomes you are trying to improve.  Fewer hospitalizations for complications from chronic diseases, such as COPD, high blood pressure or diabetes? Reduced hospital acquired infections? Reduced pneumonia mortality rate? Increased full-term births?

“I can’t stress this enough. If the sole reason you launch a new service line is because you think you can bring in more revenue, you will fail. You must decide where you can have the most impact on improving patient care, and build a program around that. With better utilization of your resources, better coordination and integration of patient care, and a little creativity, the financial impact to your bottom line can be considerable.” – Mauricio Sirvent, General Manager, Neurology

Simplify the complex

While there are already proven telemedicine models in teleNeurology, teleStroke, telePsychiatry and teleICU, many specialties require surgical, invasive, or interventional procedures that can’t be performed via videoconference. However, when pre- or post-procedure activities are considered, there may be aspects that are eligible for remote care. It is important to break down all the patient care activities to understand whether other physicians or mid-level practitioners could assist via telemedicine. For example, some of the cardiology care such as patient evaluations, follow-up on studies or echocardiograms could be done via telemedicine, which is more efficient, and more convenient for patients and physicians.

Use the bowling pin strategy

Using the “bowling pin” strategy is creating a new product or service that is very close to the existing one – i.e., the adjacent “pin”. If you have an existing teleNeurology or teleStroke program, you may already be coordinating services with cardiology, pulmonology, and vascular surgery. Adding telemedicine services in one or more of these specialties could be a logical evolution. Likewise, if you have a telePsychiatry program in the emergency department, you may want to consider expanding it to local OB/GYN practices for new mothers experiencing post-partum depression, for example.

Get creative

There are many efficiencies to be gained by balancing supply and demand throughout an organization and a region to create new service lines for telemedicine. Here are some ideas to get started:

  • Provide access to your specialists to other hospitals in your region to fill gaps in coverage
  • Create a hub and spoke model so that specialists can work out of one facility, and provide consultations throughout the region.
  • Primary care physicians can coordinate a virtual specialist consultation from their office instead of asking patients to wait weeks or months for an in-person appointment
  • Use telemedicine to improve medication adherence with your chronic care patients
  • Provide post-surgical follow-up appointments via videoconference
  • Offer scheduled telemedicine appointments in outpatient clinics
  • Physicians working in several locations could offer teleconsultations for some visits and eliminate some travel



If you would like to learn more about expanding your telemedicine footprint, please contact us to see how we can help you have better outcomes, powered by intelligence.

Read TeleNeurology as a Model for Telemedicine Growth: Part 1