Telehealth Secrets 2019: Lessons from Single Payer System - Dawniela Hightower, Eceptionist, Inc.

1. Envisioning a Landscape Where
Payment Models Don’t Rule:
What can we learn from the
Canadian Telehealth Market?
Telehealth
Secrets 2019

2. USA Healthcare Canadian Healthcare
There’s no Comparison
Payer CentricPAYMENT
MODEL
POPULATION
327.2 Million
Publicly Funded
Socialized Healthcare
37.6 Million
10 provinces, 3 territories

3. • 3.51 Million square miles - -
LAND AREA
• 37.6 Million people/
• 3.53 Million square miles –
LAND AREA
• 327.2 Million people
Area / Population : Canada vs USA

4. 10.2
per sq. mile
Population Density: Canada vs USA
87
per sq. mile

5. Canada Primed
for Telehealth
• Sparse, rural population
• Care delivery model based on
providing care to the greatest
number of people in the most
efficient way

6. Eceptionist Experience
• Provincial telehealth deployments in 6 provinces
─ Used in combination with referral solutions
• Close to 500,000 telehealth events annually –
encounters and eConsults
• Telehealth & Referral
deployments in the US,
Australia & the United
Kingdom
• First deployment in 2001

7. When
Reimbursement
Isn’t a Main
Driver . . .
Early adoption of
Canadian
telehealth

8. Telehealth Becomes
Obvious Solution When
Payment Models Aren’t
the Main Driver
•Reducing barriers to access
Saving patients millions of dollars in personal travel
costs and time off work
Reducing wait times for specialty care
Reducing clinician travel time

9. Canadian Telehealth Model – Specialty Care Follow Up
Telehealth is the standard for:
• Specialty care follow up, chronic disease
management and post acute care
• Initiated by specialty care
• ALL Adult & Pediatric specialties
• Pre-Surgical consults
• Rehab
• Chronic disease management
• Post-acute care
Patient often travels to
clinic location closest to
home
• Patient access is
supported by
provincial wide
network

10. Use Case: Alberta Health Services
─ 2017 implementation: Technology replacement
─ 10,000 users
─ Central telehealth scheduling
─ Covered lives = 4 million
─ Specialty care follow up
─ Traditional telehealth scenarios

11. ─ Improves patient care
─ Reduces unnecessary
referrals
─ Improves quality of
referrals
─ Increase access to
specialty care
─ Driven by better patient
outcomes not
reimbursement
Canadian Telehealth Model: eConsults
Asks a question
Provide medical
history
Treatment advice
Diagnosis
Primary Care & Acute Care
Models

12. Use Case:
CritiCall Ontario
─ 2008 implementation
─ On-demand consults for
urgent and emergent
patients in rural settings
─ Central Triage
─ Covered lives = 13+
Million
─ More than telehealth:
Case and Bed
Management

13. Where Canadian Telehealth
Lags Behind the US
• Patient-Driven Telehealth
─ Patient initiated telehealth
─ Patient use of personal device @ home
─ Primary care telehealth
─ Patient choice
• Innovation
• Adoption, response to change

14. What’s Next for Telehealth in the US?
Where these two healthcare
systems converge
1. Growth of specialty care-
initiated telehealth
2. Growth in on-demand consults
for emergent patients / Tele-iCU
for rural hospitals
3. eConsults supported by new
federal /state reimbursements
models
• CMS 2019 CY Physician Fee
Schedule
• More private payors recognize
cost savings

15. www. eceptionist.com
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