Telehealth is a big strategic priority for most health systems, but for most organizations it’s a work in progress.

Those are some of the key conclusions from an in-depth survey of senior executives at 38 large health systems with average annual revenue $5.3 billion from the Center for Connected Medicine and The Health Management Academy.

Today, the use of telehealth, or video doctor visits, accounts for less than 10% of total healthcare delivery at big health systems, the survey says. Only about 23% of all patients thus far have tried a telehealth session, according to the survey. But in the next three years, all the health systems participating in the survey expected that telehealth will continue to account for a bigger part of delivery of care, including 45% of significantly more than 10%.

“Telehealth represents a low percentage of total care delivery at all responding health systems, yet executives unanimously anticipate growth in the next three years as reimbursement increases and consumer demand picks up,” the survey says.

The biggest hurdle to more widespread use of telehealth to deliver patient care is payment. 70% of health system executives list lack of reimbursement by Medicare, Medicaid and commercial health insurers as their biggest barrier. A distant second at 17% was restrictive regulations followed by cost of technology at 10%. One-third of respondents said they had “other” issues as barrier to rolling out telehealth on a wider scale including provider availability, readiness and interest, workflow adoption and funding;

“For 2019, reimbursement from government and commercial payers remains the greatest barrier to telehealth adoption,” the survey says. “This lack of funding is challenging for health systems in adopting and expanding telehealth services, with 70% of executives ranking lack of reimbursement as a top barrier to greater telehealth adoption at their health system.”

Other key findings include:

• In 2019, health systems expect internal funding (70%) and patient co-pays / out of pocket payments (47%) to provide the majority of funding for telehealth services.

• When considering a telehealth technology system, health systems’ top priorities include integration with the clinical workflow (67% of respondents) and ease of patient triage and virtual follow-up (57%). Lower priorities for technology features are high-quality video chat, secure messaging and chatbot capabilities.

• In 2017 the majority (71%) of health systems reported clinicians were supportive of telehealth services.

“While most health systems have not calculated an ROI for their telehealth services, many consider developing the patient connections and the associated potential downstream revenue as a proxy return on investment (ROI), the survey says. “Additionally, telehealth can be viewed as a cost saving initiative as these services can help prevent unnecessary visits or admissions, freeing up physician time to manage patients with more serious conditions.”

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