Delivering physician services to residents of senior and assisted living facilities has always been challenging, particularly in smaller facilities. The patients are older with multiple chronic conditions. Many have limited financial support. A recent article discussed the use of telemedicine as an "instant" link to patients in these settings (see: Telemedicine Gives Long-Term Care Facilities an Instant Link to Healthcare). Below is an excerpt from it:
Telemedicine platforms like Signature Healthcare's YourDoc2U are reducing costs and improving outcomes in senior and assisted living facilities across the US. A telemedicine platform launched by a Kentucky-based long-term healthcare system is poised for growth after officials say it helped one facility decrease costs by 30 percent. YourDoc2U, a startup created in 2015 by executives at Louisville-based Signature Healthcare, is now being used in 40 Signature LTHC and rehabilitation centers in four states....The company is following a tried-and-true business model for telemedicine platforms in senior, assisted living and long-term care facilities: Set aside a kiosk or room with a secure, private audio-visual connection, provide a mobile cart with devices that can capture a patient’s vital signs and transmit them securely, then connect on the other end to a clinician who can conduct a real-time virtual visit. A separate connection allows family members to listen in on the visits. The telemedicine cart can also be moved to a patient’s room if the patient is incapacitated. Dorian Goodman, who oversees 12 Signature LTHC facilities in Tennessee and Kentucky, said one 128-patient center saw a roughly 30 percent increase in profits using the telemedicine platform, primarily through reduced transport costs and better medication management. He said the platform is especially helpful for patients with conditions such as pulmonary disease and dementia, as well as those which might require specialist care and transport to and from a distant hospital.
Here is a list of possible benefits of telemedicine for senior care facilities (see: Should your facility try telemedicine?)
- Improved access to care
- Competitive advantage
- Better risk management
- Regulatory compliance
- Increased revenue
As the first link above emphasizes, it's important to have a kiosk or room in the facility with a secure, private audio-visual connection and a mobile cart with devices that capture the patient’s vital signs and transmit them securely. In many telemedicine scenarios, patients will be of relatively low acuity or known to the physician or nurse practitioner so observation of vital signs may not be necessary. With older and chronically ill patients in long-term care facilities, it's critical for the remote physician to have access to the patients' vital signs.
It's interesting that the excerpt above cites about a 30% increase in profits for facilities with telemedicne platforms. In previous blog notes about telemedicine (see: Xerox Enters the Rapidly Maturing Telemedicine Business), I emphasized the financial advantage of a telemedicine program for health systems. Here's an excerpt from that note:
There have been a number of bullish signs that telemedicine is reaching a critical mass such that larger hospitals without a program may start to feel anxious. This anxiety may also become more acute in the face of federal cost reduction programs because telemedicine provides a way to increase patient services without investing in bricks and mortar. I have been blogging about telemedicine for years but it has remained a marginal form of healthcare delivery until recently.
Obviously, long-term care facilities already have made their investment in bricks-and-mortar. However, it can be expensive for physicians to travel facilities for, say. one patient with acute problems. Hence the emphasis on the increased revenue resulting from a telemedicine program discussed above. For long-term care chains, I suspect it would make sense to hire a physician to provide telecare visits to residents across multiple facilities.