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Camille Baxter:
Hello, and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare custom media. I’m your host, Camille Baxter. And today we are speaking with Ron Emerson, global healthcare lead at Zoom, and Ron Strachan, the principal of Optimize Health IT and CIO advisor for Zoom. Today, we are discussing how decentralization is becoming a major theme for health and life science organizations, and what that means for virtual communication. In addition to his experience at Zoom, Ron Emerson is a former member of the board of directors for the American Telemedicine Association and chair of the industry council. He has more than 20 years experience in the healthcare industry, having worked on a number of telemedicine programs in 46 countries.
Prior to his work with Zoom, Ron Strachan was most recently the SVP and CIO at McLaren Healthcare in Grand Blanc, Michigan. Ron has been working in information technology for over 35 years with his primary focus on healthcare IT for over 30 years. Before we dive in, we’d like to thank our sponsor. Zoom helps health organizations achieve a hybrid care delivery model to meet patients where they are, extend medical education, and run seamless administrative operations. Their scalable and secure platform is the trusted choice for dynamic organizations, from pharma biotech companies developing therapeutics, to medical device companies, to hospitals caring for patients. Ron and Ron, thank you so much for being here today. I’m looking forward to our conversation.
Ron Emerson:
Thank you, Camille. It’s great to be here.
Ron Strachan:
Thank you. Happy to be here, Camille.
Camille Baxter:
Great. Well, let’s jump into this topic. So, Ron Emerson, starting with you, can you give us an overview and tell us a little bit about what the rise of digital first healthcare means to you and what does it mean from a care delivery model perspective?
Ron Emerson:
Thank you very much. When we talk about digital first, I think the first thing to recognize is that we’re not talking about digital only. We’ve all learned a lot during COVID and the pandemic, and Zoom has as well. What we’re seeing with this hyper digitalization of technology is a realization that reaching people and patients where they are based on the actual clinical situation has a lot of benefits. So we are seeing organizations that are setting up digital first models using inclusion exclusion criteria, and that can decrease the entry point and barrier point of how people access the healthcare system, so we don’t have exacerbations, right? They could be different models, but proud to say, Zoom is actually the market share leader when it comes to video assisted virtual visits. So more people see their clinicians over Zoom than any other platform. The first question is who are we here to serve in healthcare, which is the patient.
So we actually did a survey, and what we found is that if you look at patients who have actually received a video assisted virtual visit, so they’re in their home, on their mobile device or whatever that may be, with their provider, that 62% of them actually preferred and want to use a hybrid model of care. And I don’t think that’s overly surprising. 34% said, “You know what? We want to stick to traditional in-person visits.” And then 4% said, “We just want to do video only.” So what digital first means is that when appropriate, just how we interact with our banking system and others, how can we leverage technology to increase access to care, decrease exacerbation so we don’t have to use more complex, more expensive forms of care, and then of course increase the convenience and the efficiencies within the healthcare system.
Camille Baxter:
Thank you so much for that explanation, because I think it really helps us when we hear those terms to get a broader perspective and understanding of all of the aspects that go into this concept of digital first. So, Ron Strachan, as we move towards digital first and new delivery models, what does that mean in regards to technology support, service and security, for example in the home?
Ron Strachan:
Sure. There’s a lot to consider, and meeting the patient where they’re at, the provider needs to consider privacy and security issues and make sure that it is secure as possible. There’s no magic bullet that protects everyone from hackers et cetera and malfeasance, as far as privacy and security. However, the providers need to consider what they need to do to make those connections as secure as possible, in addition to how secure is the platform of their partner, and ensuring that there is when available encryption to make sure that the patients also realize that in a televisit it’s as secure as possible, but there still could be some things that could go wrong. And I think today, most people understand that. With all the breaches and hacks and especially over the last four or five years, it’s a common everyday circumstance and I think people today get it. But even though with a higher consumer and patient understanding of it, it doesn’t let the providers ignore their obligations for privacy and security as well as the organizations that provide platform to do same.
Camille Baxter:
Yeah. So it really is a process of the patient becoming more comfortable with the security. So, Ron Emerson, when you think about decentralized healthcare, what does that mean to you and what are some of the trends you’re seeing and how do you see those applying to real life healthcare?
Ron Emerson:
It’s interesting, Camille. As you know, the global healthcare lead and having a global role, I meet with healthcare systems around the world quite frequently. I was actually on with Australia last night, talking about Hospital at Home, which is a great example of course of decentralized healthcare. And when we say decentralized healthcare, just for sort of a more definition, when we look at the provider space and providing clinical services, it’s, how do we reach across the continuum of care and provide services that patients would’ve otherwise had to walk into an actual physical facility to do. And when we decentralize that by increasing that access to care and equipping the same level of clinical services, we really provide another level. We decrease cost in many ways. Then there’s just some of the basic things like with hospitalizations, like the decrease of nosocomial infections.
And there’s some really interesting data points on it. One of the points is, okay, let’s look at decentralized care. Video assisted virtual visits could be considered decentralized care. We’re reaching people where they’re at in their homes, on their mobile device. Kaiser actually just put out a study not too long ago saying that they believe that 70% of urgent care visits can actually be provided virtually, right. They can be provided virtually. University of Pittsburgh Medical Center did a study which is really interesting because we need to know that the clinical efficacy, which is what Kaiser just talked about, what they can actually provide with subjective and objective data in healthcare. But then of course we have to look at the cost and what are the benefits on that side as well.
And University of Pittsburgh Medical Center, as I said, they did the report and their study, and they’re a payer provider, and what they found is that when they do an urgent care visit, on average, they save $128, and they actually tracked it for three months. So it’s a durable treatment. It’s not just, they looked at it today and then they said, “Okay, today we stopped that patient from going to the emergency room,” but we actually tracked it for three months and that patient actually did not have to get additional care outside of the actual video assisted virtual visit. And then when we look at Hospital at Home, Mayo and Kaiser actually invested in a company that’s doing Hospital at Home and some of the estimations are around 30% of all hospitalizations can actually be avoided and be provided in the home. And some of that as we start is actually just post-discharge for such things as surgical, some chronic disease for specific exacerbations, but they increase the level of care.
I believe the number last time I saw was there’s 239 Medicare approved facilities right now that can do Hospital at Home. But when you talk to Australia, they’re actually even more advanced and they’re really, really rolling this out. So in the US from a competitive perspective in decentralized healthcare is… There’s some other studies I just recently saw that one of the key decision makers of how people choose their healthcare organization is by access to care and how actually they can access their clinicians. So we do see a global shift in the private sector and the public sector of reaching people where they’re at. When I say decentralized, and I think the key point is, we’re not saying… Just like when we say digital first, it’s not all or nothing, it’s based on the actual acuity or the intent of the actual procedure, and that just continues to expand the decentralized space.
But it does add complexities, and I’d be interested to get Ron’s opinion on, how do we support that? Because you have [inaudible 00:08:53] medical equipment, you have CPAPs, BiPAPs, you have communication with the providers, you have nurses, you have IVs. And we’ve been doing a lot of these things in the home for quite some time. Labs, how does that all work? So it increases the complexity at some level, but it also just really, really changes the view of how we provide care to the people that need it the most.
Camille Baxter:
Really interesting data points and absolutely, Ron Strachan, I’d love to get your perspective on this as well and how you see hospitals supporting Hospital at Home and other models that decentralize healthcare outside the physical walls of the hospital.
Ron Strachan:
Sure. I think there’s three major components if an organization is going to be successful in providing non-traditional care settings like Hospital at Home. So we have medical devices that are being designed and deployed to patients directly that are web enabled. You know, the internet of things. And more and more devices are being added every day, they’re becoming simpler to use and operate, connectivity becomes a lot easier and it’s attributable to the patient and often to the organization that they’re receiving care from to help them get set up and again, with a secure connection. I’ve used some of these devices, they work pretty well. So there’s an enablement of certain medical devices that will allow care to be delivered again a non-traditional way. And I think someday in the near future, we’re not going to be saying non-traditional anymore, that this is going to be an everyday occurrence, and in many cases, the preferred way to deliver care.
There are going to be some procedures and care that will still be in person. I’m pretty sure that knee replacements will still be done in an OR for the foreseeable future. However, recovery is going to… And it’s already starting to look different where, if you have a joint replacement, we’ll continue with that example, the team wants you to get up and moving on that joint and start using that joint and they want you to move about and get on your own as quickly as possible, because it’s good for the recovery, but it’s also good for you as the patient because you recover better at home in many cases. The video and audio component of that is you don’t have to go back to the office to have a check in. You don’t have to be voice only to have a check in after a procedure and the providers can see you, see how you’re doing, and even look at the wound if they need to. So that’s very enabling.
And then finally, for more complex care with all the tools available and new tools that are still coming, we still have the ability to get, for example, home care agencies, and if we need a provider of some sort to be in the home, it becomes a lot easier and schedulable instead of the patient having to get in their car or somebody take them to an office or a hospital, et cetera, and again, that’s better for the patient. So I think this is a, not to be cliched, but a seismic shift in how much, not all, but how much of care will be provided into the near future and beyond.
Camille Baxter:
Yeah, it really is redesigning the landscape of healthcare. And I loved your point about what’s non-traditional right now is going to be in probably short term, what we really see as traditional healthcare and the way that care is delivered going forward. This has been so interesting for our listeners and for myself. And any final thoughts that either of you would like to share before we close today?
Ron Emerson:
One last thought from my perspective is, having been in telehealth in virtual care for many, many years, almost 25 years, we just had this really unique opportunity. And we went through this recent experience that we were thrust into and just to keep that momentum is very important. And I see it on a variety of levels of why I sincerely believe it’ll continue to grow. There’s the competitive nature of healthcare, of how to retain and to basically get more patients to come to your facility and to the others.
The other thing I think that’s very exciting when we look at decentralized healthcare and digital first is, about 40% of Americans right now are underneath alternative payment systems, right? So it’s not just about fee for service, where when you see the doctor, the organization gets revenue, it’s about capitated rates where they’re getting a certain amount of money and they have to provide care. So this really opens up… It makes it much more flexible about how organizations… And it’s more about the care team taking care of the patient. So it’s not just about the clinician seeing the patient, it’s about how does the care team provide education to people where they’re located in impactful ways, like let’s say for wellness and prevention, for education to change behaviors, so we don’t have those exacerbations.
So it’s how do we do better care coordination, discharge plan, where the patients is in a larger center of excellence, but they live two hours away. How do we care coordinate where we have their primary care doctor who’s two hours away involved, we have the caretaker who might be the son or the daughter, who’s going to be going in the home, and then they have the nurse who’s going to be going in the home and taking care of the patient. How do we coordinate all of that together? And now with capitated rates and as we move more towards value-based care, those things are feasible and we know that they provide better outcomes. So we just need to keep our eye on the ball, as we look at decentralized healthcare in digital first, that it’s not always just that interaction between the provider and the patient, it’s the overall holistic care of how we can provide better outcomes for our patients.
Camille Baxter:
Thank you so much. Ron Strachan, your final thoughts. What do you want to leave our listeners with today?
Ron Strachan:
Sure. I think it’s the power of what if? What if we can meet the patient where they’re at? What if we can provide the care that they need in a more convenient setting, and how will that drive higher patient satisfaction and most importantly, better patient outcomes? And if we continue and organizations focus on patient outcomes and patient satisfaction, then I think we’ll continue to see good things happen, where we’re meeting patients where they’re at, and providing the care that’s appropriate for whatever setting that they’re in or what they need.
Camille Baxter:
Ron Emerson and Ron Strachan, thank you so much for taking the time today to talk to us and for helping us to better understand the changes and where decentralized healthcare is going.
Ron Emerson:
Thank you very much, Camille. It’s a pleasure to be here.
Ron Strachan:
Yes. Thank you very much.
Camille Baxter:
This has been a sponsored episode of Healthcare Insider created in collaboration with Zoom. For more information about Zoom, visit Zoom.US/healthcare. I’m your host, Camille Baxter. Look for more episodes of Healthcare Insider at modernhealthcare.com/podcasts or subscribe at Apple podcasts or your preferred podcaster. Thanks for listening.
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