Modern Healthcare | Dave Barkholz
Telemedicine has become mainstream enough that vendor Teladoc could soon provide post-surgical patients at Jefferson Health in Philadelphia the option of virtual after-care checkups, Teladoc CEO Jason Gorevic said Tuesday.
Speaking at a Nashville Health Care Council luncheon, Gorevic said virtual care also offers rural hospitals the chance to keep patients close to home for treatments rather than losing them to the cities and suburbs.
About half of all rural hospitals, many suffering from declining populations and shortages of physicians, especially specialists and subspecialists, have no telemedicine capabilities, a consultant said.
Teladoc is the national leader in telemedicine with 20 million members signed up by employers, health plans and providers. That membership allows the consumers to call or use the internet for a remote visit with a Teladoc-contracted physician. The service costs about $45 for a primary-care visit and $75 for a specialty such as dermatology, Gorevic said.
At the Nashville luncheon, Gorevic said Jefferson Health, the parent company of Thomas Jefferson University Hospitals, wants to offer that convenience to patients after surgery to save them the time and expense of an office visit.
Teladoc has grown exponentially over the past three years and is on pace to facilitate 1.5 million patient visits in 2017 vs. 950,000 in 2016 and 575,000 in 2015.
When a patient visits Teledoc online or telephones its call center, Teladoc connects the patient within seven minutes to a board-certified physician licensed in that particular state, Gorevic said. States require that physicians practicing in a state, even remotely, be licensed there.
Rural communities, Gorevic said, often “don’t have many of the specialists and subspecialists,” requiring patients to travel long distances for care.
That’s a problem, said Scott Phillips, managing director of healthcare consultancy Healthcare Management Partners.
Rural communities can’t provide enough volumes to attract specialists and patients often must go to city and suburban hospitals unless they have telemedicine capabilities to get their care remotely, Phillips said.
One neurologist needs to operate in a population of about 100,000 people to sustain a practice. Many rural communities have populations of 6,000 to 10,000, which isn’t enough to attract a specialist let alone fill hospital beds.
As a result, 100 rural hospitals have closed over the past five years and many of the 1,300 rural hospitals that remain are teetering financially, Phillips said.
Telemedicine, in contrast, allows those patients to get after-care for surgeries and other treatments, including cancer chemotherapy, without having to travel far from their rural communities, he said.
“The obvious solution is not to move the doctors but move their knowledge to the rural communities” via telemedicine, Phillips said.
Last month, Teladoc won the right to operate more broadly in Texas after new legislation opened the door following a six-year, $13 million-plus legal battle with the Texas Medical Board, Gorevic said.
Texas has dozens of rural providers whose patients now have greater access to telemedicine, he said.