P1028 - Telemedicine: We Build It, They Came, Now What?

The COVID19 pandemic brought telemedicine from pilot project to mainstream practice in the matter of a few weeks. The natural progression to move from a well-researched clinical trial to a self-supported clinical enterprise has proven to be perilous for most programs. This talk will review the steps required to successfully jump this chasm and point out the unexpected pitfalls along the way. Capturing and sustaining some benefits after the COVID19 pandemic will require practices to reflect, recognize and quantify the value that telemedicine can bring to their patients and families. Rightsizing your program is the key to achieving financial sustainability and being able to offset the fixed costs of your equipment, connectivity and telepresenters. With new accountable care reimbursement plans, using telemedicine to help your organization achieve pay for performance measures may be more lucrative than the traditional fee for service models.
Quality of care standards recommend routine health maintenance visits every three months for children with a variety of chronic conditions including asthma, attention deficit hyperactivity disorder, diabetes and obesity. Many urban primary care practices experience a no-show rate of close to 50% for these health supervision visits. Barriers to access, competing demands for parents’ and students’ time, and financial constraints are all cited as reasons for this poor adherence rate. Direct to patient telemedicine within the patient centered medical home may offer solutions to most of these issues as long as service can be safely and conveniently brought to the child either at home or at school.