4 Questions with American Telemedicine Association CEO Ann Mond Johnson

The new leader is evolving the nonprofit telemedicine organization to support the industry's expanding focus.

Telehealth is evolving. So is the nonprofit organization that supports this industry.

How might these dual changes impact health systems? American Telemedicine Association (ATA) CEO Ann Mond Johnson joined the organization in March and recently spoke to HealthLeaders about the evolution of the industry and the ATA. The new leader of the nonprofit association based in Washington, D.C., is steering the organization in a new direction to provide even greater support to its membership of more than 10,000, including health systems and healthcare professionals. 

Johnson shares:

• Why it's valuable to expand the industry conversation beyond reimbursement to talking about how telemedicine ensures that people can get care when and where they need it
   
• Why companies like Walmart are spurring change
   
• A need to address the adoption gap in direct-to-consumer strategies
   
• The need for innovation at health systems to advance the practice of telemedicine
   

Johnson has extensive experience as an entrepreneur and executive leader, building and launching companies that leverage data to improve the healthcare experience for consumers. Before joining ATA, she was CEO of Zest Health. Prior to that, she served as board chair and advisor to Chicago start-up ConnectedHealth (now part of Connecture). Johnson sold her first startup company Subimo to WebMD in 2006 and began her career in healthcare data and information with The Sachs Group, which is now part of Truven Health Analytics/IBM Watson Health.

Following is a lightly edited excerpt of our discussion.

HealthLeaders: What does the ATA do, and how is it changing?

Ann Mond Johnson: The American Telemedicine Association, the ATA, has been around for about 25 years, and it is the oldest and largest organization focused on the broad dissemination of telemedicine/telehealth services. I use those [terms] interchangeably. On the one hand, we're very focused on policy and ensuring that the barriers associated with telemedicine and its dissemination are removed—those can be regulatory, reimbursement, or a host of different things. On the other hand, we focus on the resources and tools our members need to ensure that telemedicine is readily adopted, and accelerate adoption and engagement on the part of providers and consumers.

The ATA has really been the only [industry] organization solely focused on telemedicine. [Yet because of] technology, [our members] now use a number of different mechanisms, such as text, AI, and chatbots, that extend well beyond what was contemplated when the ATA was first started. Think of a matrix where on the X axis there's synchronous and asynchronous; on the Y axis, there's provider-to-provider and provider-to-consumer. If you look at those four quadrants, that is where we play. It's pretty broad, and it is a lot broader than a monitor where you and I have synchronous communication.

HL: How can you help health systems move telehealth forward?

Johnson: We can support the movement of telehealth and support health systems as they move telehealth forward in a couple ways. On the one hand there is the policy and the advocacy arena. In our world we've had some great successes in telehealth as it relates to the CHRONIC Care Act and other legislation … that has occurred both at the federal and state level. That is wonderful, although this predates me.

What we're doing going forward is to really to talk about why we're here as an association, as an industry. We're here to ensure that people get care where and when they need it, and when they do, they know it's safe, effective, and appropriate, and that providers can do more good for more people [through telemedicine].

The advantage of talking about why we're here is that it really changes the story arc. It enables [collaboration with] other organizations who have a vested interest in removing barriers associated with telemedicine just like we do, but they're not solely focused on it. It enables us to be much more of an amplifier and a convener.

HL: Tell me more about how this focus helps the ATA evolve.

Johnson: The barriers are real as it relates to reimbursement. But at the end of the day, talking about CPT codes is not a conversation that policy makers, regulators, and lawmakers can engage with. But talking about why we're here and casting it almost as a social injustice if [telemedicine is] not available, I think is much easier for people to emotionally connect with and resonate with.

If there's a hospital system that says, "If there is a cell tower available, we have an obligation to provide care"—that's the kind of thinking that health systems need to do, and we need to support them. We need to ensure there's broadband and things like that. So that's one thing.

The other is in the tools and the resources to accelerate the adoption engagement. What I mean by that is that if you look at the availability of virtual services, it's pretty broad. Over 90% of jumbo employers are offering it; over 50% of all employers are offering it to their employees. Health plans are offering it. There are a lot of direct-to-consumer options. There are a lot of ways that people can access it, and yet studies have shown there's only a 20% uptake on the part of consumers. That's a pretty big gap. We have to help close that [gap] through a number of different initiatives, and that's the second part of what we need to do to support health systems in all of this.

HL: What are the top barriers you are tackling from an organizational perspective?

Johnson: During the ATA's annual meeting in April, the charge, or admonition, to us was that if all we do is use technology to replace a visit, then we will have sold the whole industry short. In other words, we have to reimagine care. Technology and telemedicine cannot be a sidebar thought. It has to be baked into the system of care because telemedicine is medicine. It is a modality of care. So I think that's an important barrier [to address].

The second is, if we're charging people to reimagine care, we have to give them specific tools to do that. That includes creating a culture of innovation, encouraging innovation within systems.

Those very targeted issues are ones that we can focus on as an association, but I also don't want to lose sight of the fact that there are real substantive barriers like reimbursement. That's a real issue. There [also] are issues of interoperability that prevent the kind of workflow that you want to have happen.

That being said, what I always remind my members and my clients is that Walmart is not waiting for reimbursement. They're getting into [the healthcare industry] because they maintain that we're not doing a great job as a delivery system. They know their customers need certain services, and they're going to make sure they have it. That's why I think it's not good for us to focus exclusively on reimbursement or licensure issues.