Telemedicine's Expanding Options

Scott Mace, for HealthLeaders Media , April 29, 2014

One chief medical information officer whose health system is moving into this type of telemedicine is leery of allowing services such as Teladoc to permit health systems to outsource their primary care capability.

"Don't ever outsource your core business," says Shez Partovi, MD, vice president of informatics and CMIO in Dignity Health's Arizona service area. "Our core business is delivering care. I'm not sure if health systems should outsource their core business."

Still, Partovi is just as optimistic about the growth of direct-to-consumer telehealth services. Like many other health systems, Dignity already does thousands of internal physician-to-physician telehealth consults annually. As accountable care and patient-centered medical home efforts expand, the demand for direct-to-consumer telehealth at Dignity is the next big telehealth wave, he says.

So far, Dignity Arizona has started with a small pilot, training three physicians to respond to its own direct-to-consumer telehealth service last fall and launching the service in the fourth quarter of 2013. So far, only about 20 consults are happening monthly, Partovi says.

Part of Dignity's approach is to deeply understand how video encounters change the doctor/patient experience, including on-site testing where doctor and patient are both on site, but in separate rooms, and Dignity studies the interaction, Partovi says. "We have a lot of focus on understanding the user experience," he says.

Still, Dignity plans to have as many as 250 physicians trained in the next phase of the rollout, and Partovi is also chairman of the telehealth committee for all of Dignity. Partovi says there are markets where Dignity will compete with the Teladocs and American Wells of the world for the business of employers seeking direct-to-consumer telehealth options.

Ultimately, such competition may also hinge on health systems providing a broader set of offerings to employers than just telehealth, Partovi says.

"Last year we actually responded to two RFPs where it was broader," he says. "It was about providing a medical community for the employer, and we feel that's a key part of our strategy."

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This article appears in the April 2014 issue of HealthLeaders magazine.

Scott Mace is senior technology editor at HealthLeaders Media.
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1 comments on "Telemedicine's Expanding Options"

Dr. S Khattab (5/1/2014 at 11:12 PM)
Very interesting attempt to help the process of providing for the ill. However, it is not clear what is being provided from the following list of Medical Services: Engaging the patient, inviting patients to share their medical history in confidence, taking a FULL history, more engaging, sharing the analysis by provider to patient, suggesting methods of physically examining the patient over the waves, recommending a path to solve the diagnostic problem, ordering diagnostic tests or images, more engagement regarding the tests when results are available, recommending the next step whether in the form of more counseling or specialist input, discussing a treatment plan or if incurable just wait and your illness will spontaneously disappear, a different plan of action, prescribing a remedy without physical exam, following up on the advice provided to the patient and being responsive as well as responsible to the patient, recommending a return tele-medical visit to discuss patients progress with the tele-medical recommendations.




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