Episode 96: The Increasing Importance of Telehealth for Small Practices

COVID may have sped up the adoption and use of telemedicine, but it’s likely here to stay even as COVID impacts wax and wane. Patients are indicating a desire for telemedicine beyond COVID safety measures. In this episode, Michael and Scott discuss some of the recent statistics on telemedicine use among patients, and how practices can leverage telemedicine to provide more convenient care options to patients, compete with larger health systems, and better support patients during the process of seeking care.

Engage With Us

How to listen: shows.pippa.io/paradigm-shift-of-healthcare/howto

Our radio show on Healthcare NOW Radio – Weekdays at 5 am, 1pm, and 9pm ET
https://www.healthcarenowradio.com/programs/paradigm-shift-of-healthcare/

Archive of previous episodes: https://www.p3practicemarketing.com/paradigm-shift-of-healthcare/

Follow on Twitter: https://twitter.com/p3practicemktg

Full Transcript

Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans, and many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and here are some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the Paradigm Shift of Healthcare and thank you for listing. I’m Michael Roberts here today with my cohost Scott Zeitzer. This show is focused on the many ways healthcare is changing and how the consumerization of healthcare is affecting practices. We talk about this topic on a regular basis at p3practicemarketing.com, and we invite you to be a part of that conversation. Today, our show is entitled the increasing importance of telehealth for small practices. Scott, we’ve been talking about telehealth quite a bit-

Scott: Yeah. We really have.

Michael: It’s just something that just keeps on getting more and more and more part of the conversation. We’ve talked some about, we hinted at this a little bit in the last episode about some of the ways that we’ve seen some of our providers start integrating this, even including things like starting to push telehealth appointments more for people that are remote as patients and are starting to think about coming in to see somebody that may be the expert for a particular type of care. So this is definitely something that we’re going to be talking about more and more, there’s lots of good reasons here. So let me get the show introduced and then Scott, let you take it away with some facts for us to ponder. We’ve got lots of data to pull into this conversation.

So while COVID may have accelerated the implementation and use of telehealth and telemedicine for a lot of practices, studies and polls are indicating that patients see value in this whole process beyond just what COVID safety introduced to this. So practices who continue to find ways to provide convenient care to patients through telemedicine can differentiate themselves from competing practices. There’s so many people that have taken on telehealth and a lot of them didn’t like it, whether it was on the side of the provider or on the side of the patient, just because if you didn’t really integrate it into your practice, it was a meh experience.

Scott: Yeah. It’s interesting. So everybody just take a step back for a second, I don’t think anybody really utilized services as much as they do now, like Amazon and Shipt and delivery. And now it’s almost normal, and I think telehealth is going to be like that. And so how you integrate it into your practice, I think is critical. But the reason I say how you integrate it is, I think telehealth is here to stay. So there was this McKinsey study that basically said at the beginning of the pandemic, I think usage went up quite high, usage is 38 times higher than it was pre pandemic. Now, we’ve got 40% of the survey respondents are saying that they would continue to use telemedicine and only 11% prior, so you’ve jumped to 40% who still want to utilize telehealth. Now, those are your patients, everybody. And that’s why I’m saying, whether you should use telehealth, I say, no, I think it’s more like defining better when you should use it and how to integrate into your practice are the questions.

Please don’t walk away from telehealth if you want to have a healthy, strong practice. I think it’s going to be part of a lot of successful shifts in the way we take care of patients. I mean, Michael, we’ve all got families and we know how much time is required when it comes to seeing the doctor and if you can save some time, avoid sick people. I’ve got a new grandchild and I can tell you that my daughter, the first time mom. is like every other first time. Every time there was a sniffle, it was like, “Ahhh!” And I was talking to my daughter about, “You sure you want to bring that kid in every time the kid has a sniffle because, do they have a wellness area? Where are you bringing this kid?” Because it might be better just to make a phone call, right?

Michael: Yeah, absolutely. Okay. Yeah. Trying to find that balance between when is the right time to get into the practice or the hospital, or when’s the right time to stay away. We actually just had something this week for our family, where we just have a routine thing where we go in and all the care that’s needed to make sure this group of patients goes this way and this group of patients, in the midst of Delta, happening here. So anytime that we can avoid that, man, it just makes life so much more easy, just so much more refreshing and so much less to have to think about. We just did our first trip, our first work trip in a year and a half, and the whole process, I mean, everywhere we were at, it was just, so “Is this okay? Is this all right? Should I step outside for this part?” Or is it, and even if you’re outside, is that enough?

And so all of those COVID factors that are still going, that are still going up and down and surging and retreating at different times, that’s very, definitely a factor. But yeah, it’s just convenient too, that’s really helpful.

Scott: I think that convenient part, Michael, I think I want everybody who’s in a practice listening to this to really hear that, that convenience part. A lot of practices are essentially wired under the guise of, “Hey, I’m awesome at what I do, so they’ll line up to see me” kind of a thing. And I know no doctor walks around thinking like that, but there is an inferred kind of thing. It’s like, hey man, I’m doing the best I can, I’m busy for those of you who are not surgeons, it’s a long day for a surgeon. So they get up at the crack of dawn and they’re rounding on their patients and maybe they’re doing surgery, maybe they’re going right to clinic. And then they are doing surgery, then they’re going to go round on some patients again and believe me, it’s a long day. So I get why there’s some exhaustion.

And you throw in like, Michael, what we’re talking about, how nervous patients are being in the hospital. Imagine all those physicians and caretakers and surgeons, et cetera, trying to deal with that every day, in a hospital filled with people who may or may not have COVID, and it’s not going away so fast. So when we combine all of that and you think about all of those patients who basically said, “Huh, I was able to get taken care of and didn’t have to go in?” I could hop on a Zoom call and talk about, I don’t know, I get it, you’re not going to go in to talk about, “Hey, wow, I fell and I don’t know if I broke my bone or not.” It’s like, well, you’re gonna have to come in and get an x-ray man. I mean, I’m going to have to go take a look at that, feel that, look at the x-ray, et cetera, I get all that everybody.

I’m not thinking telemedicine is going to replace that, “Oh, we’re going to send you an x-ray machine,” that’s not what I’m talking about. But there are certain parts of the process of taking care of a patient where telemedicine is fine.

Michael: Yeah. It’s funny because I was actually, we went down to go deal with some of this regular appointment that we had. And Scott, you and I we’re recording from our respective homes right now and so our company is all-

Scott: All remote.

Michael: We’re running work, all this kind of stuff. So I’m taking my family member down to go to this regular trip and this is one that you have to do in the hospital. And so we’re on our way down and we get caught at the train, so we’re, if you’re in New Orleans area, we’re on River Road and we get stuck at the train and we’re just like, there’s a huge long line. And the whole time that I’m sitting there, waiting for however long this train is, I’m saying to my family, “You know, it’s really nice to work from home because I don’t deal with commutes, I don’t do this kind of stuff. When’s the last time I’ve had to sit and wait on a train?” But it’s so funny because it’s just that’s our minds are getting so rewired, if you do remote work, if you do remote anything like remote shopping.

Scott: And frankly, a major part of the country is getting rewired. So I get it, especially for practices that are out there, hey man, they still have to go to work. They are not managing their patients remotely. I mean, there are some support staff that are, don’t get me wrong. I’ve talked to a couple of, not office managers, but support staff that are now working from home. Great, I’m all for it, but let’s face it, the bulk of the practice is having to go in and go to work and take care of their patients. That being said, all of those patients now are being rewired. I think there’s a Managed Healthcare Executive article, and by the way, I want to give proper credit, those numbers about being 38 times, not percent, higher, that was a McKinsey study. This Managed Healthcare Executive article cited a recent national consumer survey from SBH Analytics.

And this is a key takeaway, 70% of patients preferred virtual visits over an in-person to save time. So I get it, right now it is Delta, and Michael, we were a little scared being in Vegas during Delta, everybody. We had dinner outside, it was 104°. And the people in Vegas were looking at us like we were out of our minds and we looked at them like, “No you’re crazy, we’re out doors and we’re a little bit safer.” But that’s not only going to be a safety issue, I get it. Right now, Delta is rampant and I don’t want to go anywhere unless I have to. So I certainly wouldn’t want to go in for my third follow up on X, can I just get on a Zoom call and we can have a conversation? So I really do suggest to everybody out there, have an open mind. Because a lot of medical doctors, surgeons, et cetera, are wired in such a way where habits like for even more so, for my surgeon, friends, like “We have a process, this is how we handle the process.”

We have a process, this is how we handle that process, it’s very important to understand that those processes are changing. And it’s not just changing what you’re doing to keep up. You could change what you’re doing to actually get ahead and I think that’s a critical thing. So I go back to that 70% of patients preferred the virtual visit, that’s a high number, man.

Michael: Yes. We know that it’s more convenient. Yes, we agree that people are definitely interested in this as a concept. One thing that I wanted us to start pivoting towards and take a look at is what smaller practices can be doing in the midst of all this. Because I think one of the things that any kind of technological change, it’s always assumed that the bigger organizations that just have the budgets that can make all these kinds of things, obviously they’re going to be the ones that can make this work more easily. And it’s-

Scott: They got staff, they have people to think it through, yeah.

Michael: All the different things. And so there’s an article that came out on mHealthIntelligence, which covered a survey from Coreo. And it highlighted how small independent practices are using telemedicine as a way to compete with larger groups. It’s that whole, which organization can pivot faster? And that’s really where a small practice has some advantage. So according to this report from Coreo, the telehealth adoption rate among practices went from 22% in 2019 to 41% in 2020. By the end of 2020 telehealth adoption rate had increased to 80%. Now, there’s a lot of factors there obviously. I mean, we know of practices that had to close down for a bit, they weren’t able to see patients so telehealth was really the only option they had. Yes, of course, adoption rates can increase there, but I want to pull just a few quotes here.

So like the Coreo report suggests that small and independent care providers found that telehealth improved how they delivered care by not only improving interactions with their patients, but reducing the office based delays and bottlenecks that affect outcomes. Again and convenience, but also just, man, we just get some of the stuff out of the way. There’s some interesting things that can happen there.

Scott: I think it is critical, there’s always going to be a conversation about change and adopting, et cetera. So first of all, in fairness to all the practices out there, the health insurance companies held up telehealth quite a bit. They didn’t want to pay the same amount of money, they made it more difficult to utilize, et cetera. And then when COVID hit, the insurance companies were forced to start paying for telehealth visits, and I believe that they will have to continue to pay for telehealth. So for everybody listening in there, if you’re a medical practice, pre COVID, telehealth was a more difficult conversation to have, you weren’t getting reimbursed fairly for it, et cetera and now you are. And now that you are, and to your point, Michael, it’s always going to be that balance. So, hey, I got this huge group of 50 people or we’re part of a hospital. Well, let me tell you something, man, we’ve worked with hospitals a long time, hospitals don’t change that quickly for a lot of good reasons, sincerely, and so it takes a while to pivot.

And when you’re the small practice, don’t give up so fast. To your point, Michael, you’re right, it’s like, hey, if the three of you just slowed down long enough or the four of you or whatever that number is for your very small practice and just go like, “Hey man, how do you want to do this?” And give it a try.

Michael: Yeah, absolutely.

Scott: It’s a lot easier to make those decisions, et cetera, I really do think so.

Michael: Yeah. So if you’re just joining us, this is the Paradigm Shift of Healthcare, I’m Michael Roberts and I’m talking with Scott Zeitzer today. We are looking at some of the advantages that small practices may be able to have when it comes to reacting to this force of consumerism, this need for more and more telehealth, and how convenient it is and how many ways that it can help. And it goes beyond just pure convenience and just COVID safety. We’re also looking at some of the facts that like, hey, it gets some of the office complications out of the way as well. So it’s interesting as well. This is something that we actually have a client that’s working on, one of the practices that we work with, a practice that’s even partnered with a physical therapists who can help guide their patients through some post-surgical exercises via telemedicine.

So that again, physical therapy, you think of one of those things, well, you got to go somewhere and you got to go into that facility. And so here’s an orthopedic provider partnering with PT to make that recovery process all the easier, again, this isn’t necessarily the kind of thought process that was happening pre COVID. This is a big win that can come out of, not post COVID, but out of this stage of COVID-

Scott: Pandemic, COVID or whatever you want to call it.

Michael: Or for however long it’s going.

Scott: Yeah. Think about it, if you’re in the standard practice, just seeing patients and you’re running from patient to patient, especially now with COVID the amount of cleaning that has to happen between each patient in that room where people are, how you’re staggering them, et cetera. And imagine having six or seven patients that you could just flip through. Now, deciding which patients at what point in their care can take advantage of telemedicine and which ones need to come in. I get it, that’s an independent decision for each of practice out there and how they manage their care, but it’s there.

Michael: Yeah. Scott, I actually just yesterday had a conversation with someone that’ll be a guest on the show coming up in a few episodes. But this process of talking about not only just making it easier for the patient, but it’s interesting to think about what potential revenue lines are available for practices. When you start thinking about these new ways of delivering care, new partnerships that you can set up, maybe that’s a new hire for your practice. But some of those different ways that you can be delivering care in the environment that we’re in. If you can focus on convenience more, if you can offer more service lines, either within your practice or very closely aligned with somebody, there’s a lot of opportunity here that I don’t want us to brush by too quickly. Because this concept of the small practice being able to pivot, these are the ways, like adding on additional revenue lines, be just implementing service lines, implementing telehealth in a way that’s convenient and that is covering as many areas as you can.

But there’s some opportunities for real entrepreneurial thinking here and better care at the same time. So yes, this is a very rocky time, it’s very frustrating, it’s very up and down, but this is, if you can step back a moment and take a look at these processes, a real opportunity for practice growth.

Scott: Without a doubt, you think about all the practices out there that started investing in ambulatory surgical centers. They got frustrated with hospitals, they didn’t think they were getting the OR time that they needed. And this is a perfect example of where, there really was a win-win there. The practices were able to be entrepreneurial and potentially make more money because they now had their own OR surgical suites and an ambulatory surgical center. They were able to, we had a great conversation, I don’t remember which specific number in the podcast it was where we talked to Dr. James Ballard up in Portland about how they just fine tuned their process at the ambulatory surgical center. He referred to it as almost like a pilot, who’s got a series of checklists that he goes through and everybody was in tune, and what a win-win that was.

The patient was better taken care of et cetera. Well now COVID comes, and ambulatory surgical centers, and when you talk about entrepreneurialism, it’s like how many patients were like, “Oh, I don’t have to go into the hospital?” Now I get it, there’s not like there was a magic wand, like you’re never going to get COVID if you go to an ambulatory surgical center. But certainly it’s just risks, how many risks you’re going to take, et cetera. And the ASC, the ambulatory surgical center was certainly a better option, it’s a perfect example there of entrepreneurialism. Telehealth is another example where, hey, now maybe you could see 10 patients and take great care of them. Bing, bing, bing! Because you didn’t have to wait 10, 15 minutes or whatever that time was to wipe everything down, make sure everything was good, et cetera, before you saw your next patient. And so the patient was happier, you are happier, et cetera. These are really helpful things.

Michael: What’s interesting through these different processes, we’re talking about how practices are able to take advantage of some of these current scenarios that we’re in. I think the practices that are able to take care of this the most, that are able to jump on these opportunities the most, are practices that were already trying something pre COVID. Yes, there are opportunities, step back, take a look, see what you can do to make that pivot. This is actually something that I sat in on a session at a recent conference and was able to hear some about how hospitals that had really already invested in things like machine learning, that had already invested in different ways of trying new modes of improving their care opportunities, improving convenience opportunities, these sorts of things. They’re the ones that were able to find that aha moment. We’ve been pushing all these different things and then, oh, here’s the pandemic, here’s this scenario at which we can go like, oh, all these things we’ve been doing, now we can put them into place.

So I think that as we’re talking through this, yes, here are some immediate opportunities, but I think some of those ideas that practices may have been kicking around for a while, they’ve been trying to figure out what’s the right environment for it, what’s the right time to try this new mode delivery. These are really the opportunities where, go back and reevaluate those ideas that you’ve been kicking around too. I mean, there’s the things that are proven models, yes, do more telehealth, that sort of thing. But also take a look at those ideas that you have had and haven’t known how to implement. Is this the right time? Is this the right set of circumstances to jump in on?

Scott: There are so many practices, Michael, that we speak with where we have a very similar conversation: “Hey, I’m incredibly busy, but I’m not seeing the kind of patients I want to see. I’m packed with patients, but these are not the types of patients that I want to see.” And there’s a variety of reasons for that, and the hardest thing to overcome when we’re talking to these particular clients is slowing down enough to think it through. It’s like, “I can’t talk to you about how to get better patients because I’m too busy seeing the patients I don’t want to see, but I know I need to take care of them.” And it’s like, yeah, that’s a warning sign, man. I get it, go do what you need to go do right now, but you better figure out a way to slow down enough to think. And if you don’t, well, then you’re going to be stuck in this same pattern, man, it’s not like it’s going to magically change on its own.

So there are a lot of people out there it’s like, “Man, I’m supposed to only see 40, but I see 50 or 60, but I’m not making the money I’m supposed to make, I’m not seeing the patients I want to go see, they’re not happy, I’m not happy.” It’s like, well you got to slow down, man. and you got to give yourself time to breathe and to think. It’s so critical. So Michael, that whole point about the people who are entrepreneurial before being more open to new ideas, well yeah. And so for all of you who are listening, going, “I just don’t have time to be entrepreneurial,” it’s like, you kind of do, but you’re going to have to, it’s hard. It’s almost like, I always kid with people about exercise because they’re like, “I just can’t get started exercising,” and I happen to be a person who exercises a lot. And I always tell them, do one pushup a day for a week.

And they’re like, “One, what’s that going to do?” And it’s like, it’s going to get you in a habit of doing a push up. Next week you can do five, 10. I don’t know, whatever it is that you want to go do. And the same thing goes, I get it, you’re very busy. Take out 15 minutes a day. Stop it, you have 15 minutes, and figure out what is it that you want to go do? Whatever that time slot is, you want to make it five minutes because you’re so busy? Good. Make it five and take the time to write it down. Whatever that is that you cannot guilt yourself or convince yourself, because it’ll help you become more entrepreneurial. If that’s read an article in a Harvard Business Review, or read an article on our site, we’ve got quite a bit of blogs, quite a bit of information about marketing your practice and et cetera. What’s our number one download? 50 Ways to Market Your Practice, I think, is that right?

Michael: 50 Ways to Market Your Practice. Yeah.

Scott: There it is.

Michael: It’s a quick introduction of a lot of different ideas.

Scott: It really does. And it’s like, I’m telling you guys, it takes five minutes to read that. And there’s a lot more other insights that we’ve got up there. And it’s not just on our site, there’s a lot of different places where you can go. Certainly ours is the best. [laughs] But Michael, it is about habits, a lot of that entrepreneurialism is just about getting into the habit of looking for new stuff, being open to the idea of trying things.

Michael: Absolutely.

Scott: That’s coming from a very cranky old man, me.

Michael: [laughs] I won’t comment on that. I’m going to jump to one more point before we need to wrap up for the day. So we’ve been talking a lot about how, what the practice can do here. I want to talk just very briefly about patient sentiment, about consumer sentiment here. So an SPH Analytics survey found that 38% of consumers are unsure if their health plan offers telemedicine. So we talked about how reluctant practices were to get involved in this, but hey, insurance jumped on board and actually said, “Okay, we’ll pay for it.” So practices started doing it, but a lot of patients are unsure about what their responsibility is. Am I stuck with the whole bill here? So even those among the patients that know if their plans offer telehealth, 43% don’t know the costs of the service. So one of the conversations that we’ve been having with one of the practices that we work with is that ability of the practice to really help answer patient questions.

How does the practice make it as easy as possible to get going? If they need a procedure, is the responsibility of grabbing all the medical records, all the information from the other providers, is that all on the patient or is that something that the practice can help with and should help with even, depending on the sentiment of the practice? But for the practices that are really willing to help with this stuff, can they get a patient on the phone and talk through these kinds of things? Can they work with them on their insurance plan to figure out what these kinds of things? From the same survey, it found that 31% of patients do not feel adequately informed about telehealth services. We’ve hammered so many times at this point now about how important it is for practices to communicate. And this is another step of, yes communicate about what you’re good at, communicate about what services you offer, look for these opportunities.

What are the additional things that you can be communicating to your patients about that will really help them feel more confident? Is your office staff trained up on everything that the patient might want to know about telemedicine? Can the office staff put them in touch with the billing person or whomever to help bridge those gaps? But that’s the thing, so many patients don’t necessarily know the right question to ask next, they don’t necessarily know, but when you do start hearing that reluctance about telehealth, if you hear from the patient side, digging in a little bit and understanding where their concerns might be and how the practice might be able to help.

So let’s wrap it up. We’ve covered quite a bit here. I think one of the most exciting things that we’re talking about right now is just where this entrepreneurialism has the opportunity to really explode for practices. There is so much tension around this and so much challenge around everything that’s going on with Delta and whatever’s coming next. But looking for these opportunities, really leaning into the areas where opportunities are growing, telemedicine is growing. But also, practices, we definitely recommend, take a look at those ideas you’ve been kicking around in the background for a while. What can you do to get ahead? What can you do to start changing this dynamic to where you’re not always trying to catch up? Because-

Scott: That’s right, that’s what it is.

Michael: There’s so many people that have been there, that get stuck there.

Scott: Weaponize those ideas for good, so to speak.

Michael: Absolutely. To everyone, thank you so much for listening. Be well, take care.

Scott: Stay safe, everybody.Announcer: Thanks again for tuning in to the Paradigm Shift of Healthcare. This program is brought to you by Health Connective, custom marketing solutions for med tech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.