Press Release


For Immediate Release Contact

 

Sue Ducat
Director of Communications
(301) 841-9962
sducat@projecthope.org

   

Health Affairs Examines Successes and Missing Links in Connected Health

 

February articles outline best practices and holes in adoption and use

 

Bethesda, MD -- Health Affairs' February issue focuses on the current evidence and future potential of connected health--encompassing telemedicine, telehealth, and mHealth. The importance of connected health is sure to only grow as more Americans gain access to health care and new, team-based models seek to provide better quality care in more efficient ways. The issue offers a variety of articles that explore what can entice hospitals, health systems, and individual providers to embrace telehealth and the policy solutions that can better facilitate adoption across the health care system:

 

Want to increase telehealth adoption among U.S. hospitals? Look to state legislatures. Julia Adler-Milstein of the University of Michigan School of Information and the School of Public Health and coauthors determined that state policies are influential. According to their findings, states that wish to promote the use of telehealth should explore private payer reimbursement and relaxing licensure requirements to achieve that goal. Overall, they found that 42 percent of US hospitals had adopted telehealth by late 2012 with significant variation across the country: Alaska was the highest with 75 percent, and Rhode Island had minimal adoption. Market forces and individual features of the hospital also influence telehealth adoption rates. Factors that positively influence adoption rates include serving as a teaching hospital, being part of a larger system, having greater technological capacity, and higher rurality. Factors negatively affecting adoption include high population density, being for-profit, and operating in a less competitive market.

 

You can successfully integrate technology into patient care, but it ain't easy. Just ask Kaiser Permanente Northern California (KPNC) and its 3.4 million members. Robert M. Pearl of the Permanente Medical Group provides a case study of KPNC's experience with Internet, mobile, and video technologies and identifies the two largest barriers to their use: the lack of reimbursements under the fee-for-service system and the financial and other resources needed to truly integrate these technologies into existing models of care. The health system has been at the forefront of electronic medical record adoption, as well as the use of subsequent technological tools that integrate with these data, and has seen continuous progress with a more than doubling of virtual patient "visits" in five years from 4.1 million to 10.5 million virtual visits annually. The author suggests that the ultimately positive experience at KPNC will become more common as the wider US health system catches up with these technologies and incentivizes their use through payment models such as ACOs and federal requirements that push providers to approach patient care as "pay for value" versus "pay for volume."

 

Texts and apps can also help you manage your diabetes. Shantanu Nundy of Evolent Health and coauthors analyzed how the widely used, familiar technology of mobile phones (mHealth) could help patients better manage their chronic conditions. Examining a group of seventy-four adults enrolled in an automated text messaging-based diabetes care program, they found better control of HbA1c glucose levels, higher patient satisfaction, and an overall net cost savings of 8.8 percent over the course of the six-month program. They also observed an overall decrease in costs for both the treatment and control groups, suggesting this type of approach can help health care organizations achieve the triple aim of better health, better care, and lower costs. The authors advocate for changes to the policy environment to enable mHealth's fuller potential through measures such as increased interoperability with electronic health records, clearer regulatory guidance, and stronger accountability for population health.

 

"The doctor will see you now" has a whole new meaning in nursing homes and could bring savings to Medicare. David C. Grabowski of Harvard Medical School and A. James O'Malley of the Geisel School of Medicine at Dartmouth conducted a randomized study of eleven facilities in a for-profit nursing home chain in Massachusetts to determine if switching from on-call physician care during off hours to two-way videoconferencing reduces hospitalizations and/or costs. They found that facilities that were more engaged in telemedicine could reduce hospitalizations and save Medicare a net $120,000 each per year. They suggest that the findings are useful for emerging models such as ACOs, managed care, and integrated care; and policy makers should consider ways to maximize the potential benefits of telemedicine by aligning incentives.

 

  • In a related Entry Point piece, The Honorable William H. Frist, M.D. shares his views of how empowered consumers and advances in IT will together affect the landscape in Connected Health And The Rise Of The Patient-Consumer.

Also of interest in the February issue:

 


The February issue received funding from the California HealthCare Foundation, Kaiser Foundation Health Plan and The Permanente Medical Group, AT&T, Intel-GE Care Innovations™, the Leona M. and Harry B. Helmsley Charitable Trust, Aetna Foundation, and Carlos Slim Health Institute.

 
About Health Affairs
 

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at www.healthaffairs.org. The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.