Rarely have we received as much response to a news article as we have been getting since we were the first to report that Bosch Healthcare had abruptly abandoned the home telehealth market. Here we print without comment the remarks of ATA CEO Jonathan Linkous and many other respected industry participants and watchers.
It’s a dynamic time in a disruptive industry so there are constant changes in the products, the marketplace and the players. Telemedicine, including remote monitoring, is ultimately about the services provided -- the devices and software are the technology tools that are used in that service. Be it manufacturing, entertainment, finance or medicine, we have seen almost immediate shifts in the supplier side of those markets as new technology innovations emerge. So this is unfortunate for Bosch and its employees but it is not isolated and is both a sign of what is happening now and will continue to happen. Do not mistake this for a decline in the market. It is a product of the maturity and transformation of a robust healthcare service that is starting to grow at an amazing speed.
Jonathan Linkous, CEO
American Telemedicine Association
The days of remote patient monitoring equipment being a capital expenditure are over. The cellular companies learned that it's not about equipment but subscription fees for service. The home health agencies that are successful with telehealth have hardwired the use of it into their care delivery model and have the clinical and financial outcomes to prove it. The ones who are unsuccessful with telehealth are the providers who have not shifted to value-based care delivery.
Joseph Ebberwein
Principal, Longitudinal Health
The margins are not there to add it as a gimmick for marketing. It is an invaluable tool though, and people and agencies on board with real population risk management will use it as an invaluable tool as it is effective and relatively inexpensive when done correctly. I have seen some of the newer software integrating it more instead of it being such a stand alone product. With better technology and patients more savvy to the new tech I do think the concept of tele-monitoring is not only yet to see its pinnacle of use, but will be much more of the norm for all facets of health care as the health care ecosystem gets to be merged closer and closer and more intertwined.
Benjamin Galin, DPT,OCS
Healthcare Consultant
Much will depend on how the ACA supreme court decision plays (decision coming soon) as the intent was to drive post-acute providers, hospitals, physicians and other providers to work together to manage chronic illnesses. You can't do that without technology, period. So we shall see what happens after the decision.
Lucy Andrews
Owner, At Your Service Home Care / Creative Solutions Consulting
These issues go back a long time. The late Bob Waters said it 15+ years ago in a tele-gathering, "If you're shit's go good, why ain't everyone buying it?" The industry needs fresh designers, and imaginative leadership.
Jeffrey Kidder
Founder, the hers projects, a 501c3, Hanover Health Services LLC
It's sad but true. You can't provide an unfunded, non-reimbursable service with staff and equipment that cost money. Homecare is headed back to the pre-1980 model. So sad to see [fee for service] go away, but also grateful to have served meaningfully in this sector since 1987.
Michelle Francine
Home Health EVV consultant
Yes, to seeing value add of telehealth and wanting to hard-wire it into our patient focused care model; and, yes, in agreement that this won't happen large scale until the home telehealth solution can interface with the home care EMR. Meanwhile, some will commit, invest and manage/execute on their plans to integrate telehealth, some will struggle with Point of Care and paper clinical documents, and many others will be somewhere in between, with a few falling off the edges of the curve into great success or failure leading to closure. These are seriously challenging times in our industry. Big, strategic decisions are needed, but money is tight. What to do? Money does cure many of these ills. The other great remedy is excellent leadership and management. Priceless.
Linda Scott
VP Home Health & Private Duty, Professional Healthcare Resources
One has to ask if the current marketplace and environment is big enough to support all the vendors out there. Are they nimble enough to adjust to the changes and can they provide the disruptive technologies that will provide a better way of doing business?
Bob Silverstein
Enterprise Sales Director - AcuteCare Telemedicine (ACT)
I said long ago, "The value is in the data not the gadgets" of telehealth. Unfortunately, the industry has been making its money on the gadgets for over 15 years now, but mostly through grant money that is no longer available. Medicare was never willing to pay for those gadgets despite all the clinical trials that showed the value of telehealth. There is no money in data alone for those because it can be obtained without gadgets nowadays. We saw this a while back and that is why we continued to work in that direction.
Amer Taha
CEO, Sigma Health Care, Inc.
The enterprise model of telehealth distribution is gone, this sector will no doubt continue to “shakeup.” It will be the few vendors and providers who are agile, which enables them to evolve with our ever-changing healthcare environment, that succeed. I agree with Joseph, success comes from Remote Monitoring only when it is hardwired into a value-based care delivery model if/when it is applicable to the client, which also ties in with Benjamin's comment: integration of Remote Monitoring data is key to the agency's client care management/back office software. After all, isn’t the data collected directly related to the client's care? Regarding the Fazzi Associates study, do you think that more home health providers would adopt the technology if it seamlessly merged with their current software solutions? What would make it compelling and simple to implement in todays home care operations?
Scotland Foss
Regional Director, Business Development, iHealthHome
Scotland,
Here's the relevant nuance regarding Fazzi's discoveries. Though the average usage is 28%, among large home health providers it is 85%. What that means, of course, is that the 50% of HHAs that gross $1 million per year or less are not using it at all, bringing the average down. The question is not whether those neighborhood providers will start using remote patient monitoring. The question is how long they will remain in existence. Once they're gone, simple math dictates that the average will rise.
Tim Rowan
The enterprise model of telehealth distribution is gone, this sector will no doubt continue to “shakeup.” It will be the few vendors and providers who are agile, which enables them to evolve with our ever-changing healthcare environment, that succeed. I agree with Joseph, success comes from Remote Monitoring only when it is hardwired into a value-based care delivery model if/when it is applicable to the client, which also ties in with Benjamin's comment: integration of Remote Monitoring data is key to the agency's client care management/back office software. After all, isn’t the data collected directly related to the client's care? Regarding the Fazzi Associates study, do you think that more home health providers would adopt the technology if it seamlessly merged with their current software solutions? What would make it compelling and simple to implement in todays home care operations?
Scotland Foss
Regional Director, Business Development, iHealthHome
Scotland,
Here is the relevant nuance regarding Fazzi's discoveries. Though the average usage is 28%, among large home health providers it is 85%. What that means, of course, is that the 50% of HHAs that gross $1 million per year or less are not using it at all, bringing the average down. The question is not whether those neighborhood providers will start using remote patient monitoring. The question is how long they will remain in existence. Once they're gone, simple math dictates that the average will rise.
Tim Rowan
©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com