It was abundantly clear in 2018 that there is a new reality in U.S. inpatient care. As I wrote in my year-end blog last month, most hospitals across the country have embraced the value equation telemedicine offers. No longer viewed as a novelty, telemedicine will continue to gain ground in hospitals in 2019—both in general hospitalist services and in a wider range of specialty offerings.
The bottom line is: We’ve arrived. Patient demand is growing as our population ages, while physician bandwidth, particularly in specialty areas, is shrinking. Telemedicine closes the gap by extending that bandwidth in new, cost-effective, and practical ways. One need only look at the 2018 update of the Association of American Medical Colleges’ final report on the projections of physician supply and demand from 2016 to 2030 to see it clearly: a projected total physician shortfall of between 42,600 and 121,300 physicians by 2030—a projection that is higher than last year’s report.
Against this backdrop, we predict a continuation of the trends that impacted telemedicine and the healthcare industry in 2018. That’s the new reality. However, there are a few interesting twists this year that spell more good news for telemedicine providers.
1. Contrary to earlier signs that it was saturated, the stroke care market will see more telemedicine growth.
Quick response is so critical in stroke treatment that most urban hospitals already have well-developed systems in place to provide diagnosis and treatment ASAP when patients present in the Emergency Department (ED) with stroke symptoms. These hospitals and health systems have made the investment in onsite staff and, in some cases, built their own telemedicine programs, to respond to this need.
What has surprised us is that we are getting calls for help from some of these organizations. They have discovered—just like the rural hospitals for which we provide telestroke programs—that qualified neurologists are difficult to find to staff their programs. So, they come to us to help them close staffing gaps. Quite a surprise. A market we thought was saturated is still providing opportunities for us and other telemedicine firms—opportunities that bring home the stark reality of the physician shortage.
2. Growth in teleneurology for post-stroke care.
The need for teleneurological care beyond stroke treatment brought hospitals to us in 2018 and will continue to do so in the new year. We have deployed Eagle TeleNeurology programs in hospitals to provide consults for post-stroke and non-stroke neurological conditions in the inpatient setting beyond the ED, where Eagle TeleStroke services are rendered. We already have both our TeleStroke and TeleNeurology programs in several Midwest and Kentucky hospitals, and expect growth to continue in these areas.
3. Skyrocketing behavioral health needs.
Regarding mental health services, the U.S. Department of Health & Human Services designates 5,042 Health Professional Shortage Areas (HPSAs) in which 123 million Americans live. That means only 32.52 percent of the need is being met in those areas, and it would require 5,096 practitioners to remove the HPSA designation. (See these and state-by-state figures at the Henry J. Kaiser Family Foundation website.) The growing opioid epidemic in the United States exacerbates the problem, and telemedicine can be part of the solution in providing mental health professionals for these underserved areas.
TelePsychiatry programs make up a small percentage of our total telemedicine sites at Eagle, but we anticipate growth in this area in 2019—for many of the same reasons that we project TeleStroke and TeleNeurology growth. Even hospitals and health systems with behavioral health programs in place still need help finding professionals to staff them, and in many cases, they turn to telemedicine as a solution.
4. Growth in Tele-ID services.
Tele-ID (infectious disease) has taken a back seat for years to TeleStroke, Tele-ICU and TelePsychiatry in the order of telemedicine programs hospitals wanted to implement first. There just had not been much interest in it. But we saw all that change in 2018. As a result, we have ramped up our infectious disease physician resources to respond to the requests that have inundated Eagle—and we expect to continue to do so in 2019.
I think this sudden interest stems from the fact that hospitals have been devoting all their attention to solving staffing issues in behavioral health, stroke treatment and the ICU. Now that those have been stabilized in many instances, they are mining other areas where telemedicine would be of value. Telemedicine physicians can diagnose and treat complicated infections such as complex pneumonia and endocarditis. They also can guide the hospital or health system in such ID-related practices as the optimal selection and use of antibiotics. And back to the same old story: They can relieve the headaches many hospitals face in finding qualified infectious disease specialists available to work with them.
5. Telemedicine will continue to have its place at the table.
The Maryville Forum in Maryville, Mo., published a story on Oct. 8, 2018, about Eagle Telemedicine’s new TeleNocturnist program at Maryville’s SSM Health St. Francis Hospital. The writer compared one of our team’s telemedicine visits to a Skype call in which “the doctor is able to see and talk to the patient.”
That comparison brought home to me how our industry is benefiting from the public’s overall acceptance of technology in our daily lives. After all, Skype has 300 million active users. Familiarity like that is the reason that patients and their families, physicians, nurses—everyone involved in inpatient care—is easily adapting to telemedicine. They understand the important role it plays in healthcare today, and they are often our industry’s greatest advocates. That creates a most favorable environment for us as we enter the new year.