Telemedicine’s Two Separate—and Different—Worlds for Hospitals
By Jason Hallock, MD
I talk to many hospital leaders in my capacity as SOC’s Chief Medical Officer. Lately, there’s been a recurring theme: too many vendors—and confusion about what to do about it.
I’ve spoken recently with health systems ranging from 20 hospital sites up to 100, and one said they have as many as 40 different telemedicine vendors spread across varying parts of the system. That’s not vendors in general; that’s telemedicine vendors! That’s forty different ways of delivering clinical services in a single health system, leading to unnecessary costs, severe frustration, and confusion for those at the patient bedside. Industry leaders are scrambling to make sense of it.
The Wall Street Journal covered this phenomenon in May in an article about the massive influx of investment into digital health. “We are inundated,” the story quotes one source as saying. “We already have these very big portfolios of vendors. And with all this new stuff coming into the market, there’s no way to assess, literally thousands” of digital-health services now available.
That was a benefits manager for a large company talking. But I’ve heard the same frustration from health systems. The pandemic dramatically increased telemedicine acceptance and uptake. Some telemedicine services were adopted ad hoc in response to the crisis. Hospitals rushed to stand them up when and where they could.
Now, though, health system leaders struggle to manage the aftermath, finding that many of these systems overlap. None of the telemedicine solutions can do it all, some don’t truly serve their end-users, and we must untangle the entire interwoven technology mess. Hospitals and health systems also have groups of employed physicians and closely aligned group practices. However, the roadmap to accomplishing their telemedicine goals remains murky.
How should health system leaders think about this challenge? I have a suggestion.
The two separate (and different) telemedicine worlds
The fact is that right now, and in the near future, there are two different telemedicine spaces: acute care and everything else.
The stumbling block that many hospitals have around telemedicine is that they have been looking for one solution to do everything. And I mean everything. They want the “digital front door,” the patient at home, the virtual visits, and they want the cardiologist seeing the patient with the heart attack.
But acute care telemedicine, where SOC thrives, is a different use case compared to delivering telemedicine outside the hospital’s four walls.
How acute care telemedicine is different
Acute care within the hospital is complex, high-risk, highly time-dependent care delivered by a variety of specialists. In contrast, a virtual follow-up visit to a surgical procedure, where the patient is at home, does not depend on a specialist coming on the screen within a sensitive time frame. If either party misses the appointment, it can be rescheduled.
Don’t get me wrong, all telemedicine embraces consumerism in healthcare, whether that is timely access to a specialist when a patient is in a crisis or the convenience of seeing your doctor from your home. In emergency medicine, we often opine that “patients are horizontal and customers are upright.” Acute care telemedicine is about meeting the needs of truly sick patients at the right time. There is tangible ROI for the patient and the health system when there is access to a specialist that would not otherwise be available to the patient. It embraces the very notion of timely and effective care.
Obviously, teleICU is about the highest acuity place one can find in the hospital. The demands of critically ill patients or those who require acute unscheduled care are very different from those of a patient at home using telemedicine to help manage a chronic condition.
Right now, there isn’t a company out there which is good at both kinds of telemedicine. There is a big divide—I would argue a chasm—between what is demanded of a telemedicine solution to reach patients outside the hospital and what is required in the acute care space inside.
SOC has succeeded because we’ve managed to marry a telemedicine technology platform with the delivery of specialist services, and tailor those to our partner hospitals’ particular workflows and needs. Systems looking beyond simple staffing coverage and to long-term longevity of clinical programs are poised for success with a stable partner.
We don’t try to be the digital front door to the hospital. And, in the acute care telemedicine world, when we treat patients at home, it is through a facilitated care model. Meanwhile, I think we’re the best in the industry at delivering telemedicine in an acute care setting.
As hospital leaders seek to consolidate dozens of telemedicine vendors down to a handful, thinking about those two worlds as separate entities should help drive the decision-making.
R. Jason Hallock, MD, MMM, is Chief Medical Officer at SOC Telemed. Dr. Hallock leads management of clinical and administrative strategy, ensuring that top-rated medical standards are met across all clinical specialties. Dr. Hallock is a strategic clinical and operational leader with more than 20 years of experience within some of the nation’s most highly developed clinically integrated networks. With complementary business and medical degrees, Dr. Hallock is adept at driving alignment of clinical and administrative objectives to produce optimal results in quality, safety, and efficiency. Dr. Hallock has a Master of Medical Management (M.M.M.) from the University of Southern California and an M.D. from the University of Connecticut.
You may be interested in reading more about acute care telemedicine for hospitals in: The myth is broken: investing in our virtual healthcare future, also by Dr. Jason Hallock.