Disease & Genomics

What is Next-generation Telemedicine?

Blockbuster vs Netflix. Flip phones vs smartphones. Paper maps vs GPS. Traditional banking vs online banking. We are surrounded by products and services that help us get the things we need and want -- faster, easier, and, in some cases, cheaper than just a few years ago. With telemedicine, we should expect no less.

Telemedicine for employers has been available for several years and is becoming more popular than ever. In fact, in a survey of U.S. employers with at least 1,000 employees, the strategic consulting firm Towers Watson found that currently 22% of employers offer telemedicine as a benefit to their employees, 37% expect to offer it in 2015, and another 34% are considering offering telemedicine in 2016 or 2017.

Regardless of employee count, sector, or demographic, employers understand that a telemedicine benefit can help them reduce healthcare costs, improve healthcare access, and increase employee productivity and satisfaction. However, as the telemedicine industry continues to evolve, what may not be clear is what features employers should expect and require from a telemedicine solution.

The challenges that employers have with legacy telemedicine services include laborious patient experiences, low utilization, long call-back times, telephone-only visits, low levels of customer service, limited or no smartphone/tablet accessibility, and security and privacy issues. Next-generation telemedicine provides employers with a vastly different experience than earlier models of telemedicine.

  1. Excellent patient experience
  • Next-generation telemedicine is more intuitive, more responsive, and easier to use than older models. In fact, it is as easy to use and interact with as popular consumer website and mobile apps like Facebook, Instagram, YouTube, and Pandora
  • No training is required; you simply download the app or access the website, and begin using the service. The technology enhances the ease of use instead of making it more challenging
  • On-demand care is available with an option to schedule visits with preferred providers. Call-backs are a thing of the past
  • A seamless patient experience will naturally lead to higher utilization of next-generation telemedicine versus legacy telemedicine services; one of the key barriers that employers face with legacy services is low utilization in the 1-2% range, whereas next-generation telemedicine typically has double-digit utilization

      2. Advanced technology

  • It is developed by some of the best engineers and designers, many of whom come from leading technology companies in Silicon Valley such as Google, Facebook, Apple, and Twitter
  • Telemedicine visits are conducted in high-definition video, enabling the most rich and effective provider-patient interaction
  • You can access the service with nearly any smartphone, tablet, or computer
  • Patient privacy and security are backed by enterprise-grade encryption while not interfering at all with a great patient experience

     3. No-risk model

  • Employers pay for services their employees utilize and find valuable, and not for per-member-per-month (PEPM), integration fees, or other non-service costs.

  • PEPM fees force employers to assume much of the engagement risk associated with a vendor contract

  • Regardless of the number of employees who use the service, the vendor collects the same PEPM fee, month after month. For services with low utilization, this is cost-ineffective.

  • However, a pay-as-you-go model places all of the financial risk upon the vendor and incentivizes the vendor to deliver a service that employees like - even love - to use and at high enough utilization rates to sustain the vendor's business

  • A no-PEPM model allows employers to offer the service to non-benefit-eligible and non-benefit-enrolled employees

  • Employers should expect there are no hidden costs built into telemedicine vendors' relationships with health insurance companies

  • With a no-risk model, return-on-investment is realized from Day 1 of usage
  • Full marketing programs are included with all implementations; there are no extra costs for next-generation telemedicine companies to market its services and benefits to employees

  • Full reporting programs are also included with all implementations at no additional cost; reporting should include key aggregated, de-identified employee usage data, such as reasons for visits, time of day, age, resolution rates, prescription rates, and substitution for more expensive care modalities, such as brick-and-mortar urgent care centers, emergency rooms, and physicians' offices

      4. Health insurance integration

  • The telemedicine company can work with any health insurance provider to access eligibility files, coordinate the administration of claims, and track utilization for deductible and out-of-pocket maximum levels -- all without any additional work for HR executives

  • Eligibility checks and claim filing can be conducted in real time

  • Implementation takes 4-6 weeks

      5. Regulatory compliance

  • Video is becoming an essential component for telemedicine regulatory compliance

  • Increasingly, video is being recognized by organizations such as the Federation of State Medical Boards and the American Medical Association as the standard of care for telemedicine, and necessary for establishing a doctor-patient relationship
  • By contrast, healthcare and regulatory experts regard telephone, email, and text as inadequate for establishing a doctor-patient relationship

      6. High clinical standards

  • All providers are US-trained, US-licensed and, in the case of physicians, Board-certified. They also all have clean background checks and no medical malpractice issues

  • Providers are screened, interviewed, and hired individually to assess clinical acumen, bedside manner, and fit for the telemedicine platform
  • Providers are trained specifically for telemedicine, with evidence-based protocols

  • Clinical quality is monitored on a regular basis through peer review of cases and random auditing by clinical staff members

      7. Outstanding customer service

  • A highly-qualified customer service team is available 24/7 to assist patients with everything from downloading the app to creating an account, completing insurance paperwork, internet connection issues, and prescription questions; customer service is on par with that of companies like Nordstrom, Zappos, and Amazon

  • Patients are refunded for the cost of their video visits if they are at all dissatisfied with their experiences

      8. Honest, transparent reviews

  • Employers have free access to patients' unfiltered reviews of the service that are collected and displayed on a third-party platform

  • Patients are not paid or compensated to provide positive feedback
  • Thousands (not dozens or hundreds) of reviews are available to provide a balanced understanding of what patients' experiences have been with the service

About the Author

Lena Cheng, MD, Vice President, Medical Affairs, Doctor on DemandLena is an internal medicine-trained physician and digital health expert with over fifteen years of experience in clinical medicine and healthcare strategy.

She is passionate about increasing access to high-quality, low-cost healthcare. Currently, Lena heads up Medical Affairs at Doctor on Demand, the country's largest and fastest growing video telemedicine company.

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