What Retail Telemedicine Means for Health Care Providers

by Jane Sarasohn-Kahn

Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target's pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers' homes.

Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they offer. Three in four large employers (74%) plan to offer telemedicine to workers in 2016, a dramatic increase from 48% in 2015. This trend is part of business' continued challenge of bending corporate cost curves for health and designing the health benefit to deliver lower-cost, convenient on-ramps to health care for employees looking for lower-cost services paid out by their own high-deductible health plans.

As telemedicine mainstreams to Main Street, what does the growth of retail health, enabled through technology, mean for health care providers?

Health industry stakeholders who caution against the growth of retail telemedicine warn about the potential of further fragmenting care delivery -- a real risk. How can retail telemedicine bridge back to a patient's medical home, primary care provider and electronic health record to ensure continuity of care?

Depending on how Cox Cable rolls out their telehealth offering, the project might provide a good example of how to leverage retail/home convenience while working with an established and respected health care provider.

In a release about the Trapollo acquisition, Asheesh Saksena, executive vice president and chief strategy officer at Cox Communications, said, "We believe that the home will be an increasingly important node within the health care delivery architecture."

Trapollo already has been working with employer benefits, senior living and disease management programs. Furthermore, Cox signed a joint venture with Cleveland Clinic earlier this year to form Vivre Health and is an investor in HealthSpot, the health care kiosk company that is also channeling through Rite Aid pharmacies.

A Strategy& consumer survey found that the same percentage of consumers (about 40%) trust large retailers and digitally enabled companies as trust health care providers to help manage their health. Underneath this statistic is consumers' belief that they can "trust to receive quality care at lowest cost." That trust is grounded in transparency, the kind of which health consumers -- consumers -- find in retail and eCommerce shopping formats, say in a pharmacy with posted prices in urgent care clinics delivered through a trusted store brand, on Amazon (where in some communities goods can be delivered same-day or, via Prime, in 2 days) or through one of the growing health data ecosystems growing at Apple, Google, Microsoft, Samsung or Under Armour.

There are signs that health care providers are warming up to telemedicine used by consumers for self-care. The American Association of Medical Colleges observed that a "growing body of research substantiates telemedicine's effectiveness." The American Academy of Family Practice convened a panel where Jason Mitchell, director of AAFP's Center for Health IT, asserted that, "Telemedicine is not different medicine. It's a different interaction. It's an integration of technology and care."

However, the American Medical Association adopted a telemedicine policy that focuses on the technology as a "foundation for physicians to utilize ... to help maintain an ongoing relationship with their patients, and as a means to enhance follow-up care, better coordinate care and manage chronic conditions," believing that a patient-physician relationship must be established before the telemedicine contact "to ensure proper diagnoses and appropriate follow up care."

There are signs, though, that many consumers would welcome the opportunity to interact with a physician who is not their medical home in favor of just-in-time convenience, access and price. Sixty-four percent of American consumers told the American Well 2015 Telehealth Survey that they would see a doctor via video. Consumer research among Millennials shows them to be somewhat less concerned about establishing an ongoing relationship with a physician than Baby Boomers and older patients, favoring convenience and cost.

Certain parts of the legacy health system -- nurses, pharmacists and doctors (that is, "my" doctor) -- have long enjoyed consumers' trust, according to the annual Harris Poll and Gallup Poll. Those pharmacists working in community pharmacy settings have a leg up on the nurses and doctors when it comes to retail convenience and price transparency.

Can doctors, nurses and hospitals (a trusted institution compared with, say, Congress and car dealers, the Harris Poll shows), combine their consumer trust equity with telemedicine and EHR technology to ensure care continuity and quality? This is the challenge that health care providers face in the growing world of consumer-driven retail health.

Source: iHealthBeat, Wednesday, September 23, 2015