1. Debunking all the Reasons for Not Using Telehealth
Aditi Joshi MD, MSc, FACEP Medical Director, JeffConnect Assistant Professor Department of Emergency Medicine Thomas Jefferson University Hospital

2. Objectives Introduction Background of Telehealth and Our Experience
Common Myths
Debunking the Common Myths
Overcoming the Barriers

3. WHO Definition of Health Technology
"application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives."
Medical technology, or medtech, encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies (applications of medical science) are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and reductions in hospital stays and rehabilitation times.[3] Recent advances in medical technology have also focused on cost reduction. Medical technology may broadly include medical devices, information technology, biotech, and healthcare services.

4. Digital Health
Convergence of digital and genomic technologies to enhance healthcare delivery.
Includes:
Devices
Telemedicine/Telehealth
Applications
Sensors
Home monitoring
VR/AR AI
Digital health is the convergence of digital and genomic technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and make medicines more personalized and precise.[1] The discipline involves the use of information and communication technologies to help address the health problems and challenges faced by patients.[1] These technologies include both hardware and software solutions and services, including telemedicine, web-based analysis, , mobile phones and applications, text messages, and clinic or remote monitoring sensors.[2][3] Generally, digital health is concerned about the development of interconnected health systems to improve the use of computational technologies, smart devices, computational analysis techniques and communication media to aid healthcare professionals and patients manage illnesses and health risks, as well as promote health and wellbeing.[1][3]

5. JeffConnect Jefferson’s Telehealth program
Name of our telemedicine platform
Scheduled calls
OnDemand calls for acute urgent care
Created with Teladoc platform and honed for the specific needs of a healthcare institution and its patients

6. JeffConnect’s Enhancement of the Medical Home
© 2015 Jefferson

7. Potential Telemedicine & Urgent Care Programs
Engage family members who are not present
Virtual rounds model
Hybrid models of care
Central telehealth hub
Post discharge care
Engage specialists
Virtual Urgent Care
Convenience
Reduced travel
Enhanced Care Coordination
All Video Visits
All Jefferson Physicians 24/7/365

8. Programmatic Development
Senior leadership
Leadership – Jeff is top-down
Business/strategic plan development
Goals (unmet need) of patient population
Scope of program
Approach
Understanding external forces
Legal & regulatory
Reimbursement
Consumer trends
Internal forces
Prioritizing Opportunities

9. Common Myths: Provider Version
Patients don’t want to do it
Provider uptake is a challenge
Reimbursement is difficult and not going to change soon
The Tech is too difficult/unreliable
You can’t do a proper physical exam
It’s not as good as an in-person visit

10. Myth One: Patients don’t want to do it

11. On-Demand Care: Results for JeffConnect
Survey results
Net Promoter Score > 70
Health complaint addressed as hoped > 90%
Time saved over one hour = 87%
Already recommended JeffConnect = 81%
Initially patients didn’t care if provider was Jefferson or not; we are now seeing a slight change in response
40% of visits new patients
83% would have sought care elsewhere
45% in ED or urgent care center
74% received no further care
Most sent to ED required admission or procedure
These results are in-line with other larger studies such as done by Salesforce

12. Myth 2: Providers uptake is a challenge

13. Changing Providers minds is a herculean task…
You already ‘do’ Telemedicine
We all want what is best for patients
It can lead to more efficient care

14. Myth 3: Reimbursement is not going to change soon

15. New laws and policies are already showing promise of change
Medicare bill passed 2/2018
Different states have had early adoption and about half have parity laws
Cost savings
Waiting for this to change will ensure being left behind

16. Myth 4: Technology is difficult and unreliable

17. Hasn’t stopped us from using it in other spheres
There are plans for expanding WiFi to lower income areas
Tech improves daily and reliable staff/experts can be employed

18. Myth 5: You can’t do a proper History and Physical Exam

19. History becomes important – listening to our patients
You can do quite a lot by Telemedicine exam by being creative
Always have the ability for higher level of care
Future trends suggest this will be less and less of an issue

20. Myth 6: It’s not as good as in-person visit

21. The other option might be delayed or no visit
How do we define health and healthcare?
The future is going to be home-based care
What we think of medical visits will change

22. Overcoming These Barriers
Education
Marketing
Research

23. Final Thoughts
I challenge everyone to rethink how they think Healthcare has to be practiced.
All trends point to more technological innovation.
These myths and barriers shouldn’t hold you back. Don’t get left behind!

24. Thank you
@draditijoshi