Telemedicine as business tool

"This is an incredible time for healthcare, and we need to look at it from within a specific framework in terms of the dollars and cents of it.”

Those words, from American Telemedicine Association CEO Jonathan Linkous, form the backdrop for the 2013 ATA International Meeting & Trade Show's finance and operations track, which spans nearly 20 sessions on Monday, May 6, and Tuesday, May 7.

[See also: New revenue streams for doctors]

"We want attendees to gain a better understanding of the return on investment associated with telemedicine as well as efficient ways of operating a program," Linkous said.

Healthcare entities of all sizes – from the "solo doc" independent practice to the largest integrated health systems – are working through changes in payment models as fee-for-service arrangements yield to a mix of managed care, accountable care organizations, medical homes and capitated systems.

"All of these present a different way of doing business, which is a challenge for telemedicine," Linkous said. "But mostly it's an opportunity to expand services to an environment where you can actually get the services themselves paid for or underwrite a larger system that will pay for those services as well as others."

At the same time, innovation in service delivery has opened up new prospects for organizations willing to explore new ways of running their business. "An increasing number of institutions are outsourcing portions of their services, or providing services as a unique service platform within their network," said Linkous. For example, stroke care is no longer limited to a neurologist within a hospital who provides consultations. Today, a neurologist may be situated in a central place, serving the hospital no matter where it is located.

"The hospital may even contract out to an external physician to provide neurology services," he said.

The stage is set, he added, to make telemedicine a profit center. Or, at the very least, it should be an activity that does not put a drain on finance. "Telemedicine should help both in financial as well as quality terms," he said.

"We're in a new world right now, trying to figure out how to make use of this technology," he added. "And it's important to recognize that it's not about the medical device or technology. It's about the service that uses the technology as a tool. That's where operations comes in."

A crucial operational role for telemedicine moving forward will be in reducing hospital readmissions. "The hospital knows that it is in their best interest to make sure a discharged patient will be cared for so that he or she does not go back in the hospital within 30 days," Linkous said. "The hospital will do what it can in terms of remote monitoring – but the private physician has a role in that, too. And if the private physician is aligned with that hospital, there ought to be a role in terms of sharing information, doing remote monitoring. Telemedicine is being used in that way."

"The goal is to integrate telemedicine into the practice of care – it's not a specialty unto itself," said Linkous.