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Analysis

Why Physicians Resist Telemedicine's Growth

By Mandy Roth  
   July 24, 2018

A report documents sources of reluctance and offers tips to make virtual technologies a reality.  

While telemedicine appears to be one of the greatest areas of growth for health systems, physicians aren't wholeheartedly embracing the concept, according to a new survey.

The Deloitte 2018 Surveys of US Health Care Consumers and Physicians finds:

  • While 90% of physicians see the benefits of virtual care technologies, only 14 percent have video visit capabilities today
     
  • Only 18 percent of the remainder plan to add this capability in the next couple of years
     
  • Of those who currently have telemedicine capabilities, only a third use it regularly

What's the problem? Lack of reimbursement, complex licensing requirements, and the high cost of the technologies have contributed to slow adoption, according to the report, which did not explore these factors in depth.

Reliability, access and security top the list of reasons, along with a bevy of other concerns.

The Many Forms of Skepticism
 

The study explores what it terms "virtual care technologies." In addition to telemedicine, this includes email/patient portal consultations with patients, remote patient monitoring at home, remote patient monitoring at other facilities, such as ICUs or skilled nursing facilities, remote care management and coaching, integration of data from wearable devices into EMRs, and physician-to-physician electronic communications.

Physician resistance to these advancements comes in many forms:

  • 36% are concerned about medical errors
     
  • 35% say their workplace doesn't offer these technologies
     
  • 33% have qualms about data security and privacy
     
  • 23% indicate patients are not interested or lack technology to connect
     
  • 22% feel it does not fit into their workflow
     
  • 18% cite increased practice costs
     
  • 8% aren't interested
     
  • 5% don't see a need
     
  • 11% cited other reasons
     

Health System Physicians More Versatile
 

"Physicians employed or affiliated with hospitals or health systems (62%) are more likely than independent physicians (49%) to have implemented at least one of the seven virtual care technologies," according to the survey results. "Several factors may explain this difference: capital requirements, different strategic priorities, and a greater proportion of independents being exempt from meaningful use requirements," the Deloitte report says.

The Familiarity Factor
 

Those currently using one of the virtual technologies today are more likely to adopt additional technologies in the future. The report finds:

  • More than half of the physicians (58–69%) whose organizations have adopted virtual care technologies expect to increase use in the next year or two
     
  • Only 15-33% of physicians whose organizations have not adopted virtual care technologies plan to begin using them in the future
     

4 Ways to Help Physicians Make Virtual Care a Reality
 

Health systems can stimulate interest and encourage adoption of virtual technologies by including physicians early in strategic processes and helping them understand the bigger picture. Recommendations include:

  1. Align clinicians and staff across the organization to support and advance virtual care offerings with a focus on improving quality, patient experience, and cost-effectiveness
     
  2. Create the infrastructure to support the vision
     
  3. Enable workflow, clinical process design, and integration
     
  4. Routinize virtual care
     

3 Articles to Read Now
 

Learn more about the changing landscape of telemedicine:

  • For a comprehensive look at the state of telehealth, along with its promise and challenges, read The Adolescence of Telehealth
     
  • Learn how direct-to-consumer pediatric telemedicine significantly reduces ED and urgent care utilization, along with the associated costs
     
  • Reimbursement for telemedicine may be changing. Recent CMS proposals call for doctors to be paid for the time they spend communicating with patients over the phone or via other telecommunication channels, regardless of whether an office visit or other service is rendered.
     

A Glimpse of Successful Ventures
 

Here's a look at several successful telemedicine initiatives recently covered by Health Leaders:

  • A virtual vascular clinic delivers high-quality care and generates high patient satisfaction scores
     
  • Telehealth can play a role in reducing COPD readmissions by removing barriers to health in the home environment
     
  • A Veterans Affairs program using telemedicine to improve care of critically ill patients in regional VA hospitals appeared to reduce transfers to intensive care units (ICUs) at larger facilities without compromising patient survival

 

Mandy Roth is the innovations editor at HealthLeaders.


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