News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Two New Definitive Healthcare Surveys Show Use of Inpatient Telehealth is Outpacing Outpatient Telehealth Services

Medical laboratories may find opportunities guiding hospital telehealth service physicians in how clinical lab tests are ordered and how the test results are used to select the best therapies

Telehealth is usually thought of as a way for patients in remote settings to access physicians and other caregivers. But now comes a pair of studies that indicate use of telehealth in inpatient settings is outpacing the growth of telehealth for outpatient services.

This is an unexpected development that could give clinical laboratories new opportunities to help improve how physicians in telehealth services use medical laboratory tests to diagnose their patients and select appropriate therapies.

Dual Surveys Compare Inpatient and Outpatient Telehealth Service Use

Definitive Healthcare (DH) of Framingham, Mass., is an analytics company that provides data on hospitals, physicians, and other healthcare providers, according to the company’s website. A survey conducted by DH found that use of telehealth solutions—such as two-way video webcams and SMS (short message service) text—has increased by inpatient providers from 54% in 2014 to 85% in 2019, a news release stated.

Meanwhile, a second Definitive Healthcare survey suggests use of telehealth in outpatient physician office settings remained essentially flat at 44% from 2018 to 2019, according to another news release.

For the inpatient report, Definitive Healthcare polled 175 c-suite providers and health information technology (HIT) directors in hospitals and healthcare systems. For the outpatient survey, the firm surveyed 270 physicians and outpatient facilities administrators.

DH’s research was aimed at learning the status of telehealth adoption, identifying the type of telehealth technology used, and predicting possible further investments in telehealth technologies.  

Most Popular Inpatient Telehealth Technologies

On the inpatient side, 65% of survey respondents said the most used telehealth mode is hub-and-spoke teleconferencing (audio/video communication between sites), Healthcare Dive reported. Also popular:

Fierce Healthcarereports that the telehealth technologies showing the largest increase by hospitals and health networks since 2016 are:

  • Two-way video/webcam between physician and patient (70%, up from 47%);
  • Population health management tools, such as SMS text (19%, up from 12%);
  • Remote patient monitoring using clinical-grade devices (14%, up from 8%);
  • Mobile apps for concierge services (23%, up from 17%).

“Organizations are finding new and creative ways through telehealth to fill gaps in patient care, increase care access, and provide additional services to patient populations outside the walls of their hospital,” Kate Shamsuddin, Definitive Healthcare’s Senior Vice President of Strategy, told Managed Healthcare Executive.

DH believes investments in telehealth will increase at hospitals as well as physician practices. In fact, 90% of respondents planning to adopt more telehealth technology indicated they would likely start in the next 18 months, the news releases state.

Most Popular Outpatient Telehealth Technologies

In the outpatient telehealth survey, 56% of physician practice respondents indicated patient portals as the leading telehealth technology, MedCity News reported. That was followed by:

  • Hub-and-spoke teleconferencing (42%);
  • Concierge services (42%);
  • Clinical- and consumer-grade remote patient monitoring products (21% and 12%).

While adoption of telehealth technology was flat over the past year, 68% of physician practices did use two-way video/webcam technology between physician and patient, which is up from 45% in 2018, Fierce Healthcare reported.

The graph above, taken from the Definitive Healthcare 2019 survey, shows the percentage of telehealth use among surveyed outpatient settings. “The results show how telehealth continues to be one of the core linchpins for providers,” Kate Shamsuddin, Definitive Healthcare’s Senior Vice President of Strategy, told Healthcare Dive. (Graphic copyright: Definitive Healthcare.)

MedCity News reports that other telehealth technologies in use at physician practices include:

  • Mobile apps for concierge service (33%);
  • Two-way video between physicians (25%);
  • SMS population management tools (20%).

Telehealth Reimbursement and Interoperability Uncertain

Why do outpatient providers appear slower to adopt telehealth, even though they generally have more patient encounters than inpatient facilities and need to reach out further and more often?

Definitive Healthcare reports that 20% of physician practice respondents are “satisfied with the practice’s current solutions and services,” and though telehealth reimbursement is improving, 13% are unsure they will be reimbursed for telehealth services.

The Centers for Medicare and Medicaid Services (CMS) states that Medicare Part B covers “certain telehealth services,” and that patients may be responsible for paying 20% of the Medicare approved amount. CMS also states that, effective in 2020, Medicare Advantage plans may “offer more telehealth benefits,” as compared to traditional Medicare.

“There is not only a need for more clarity around reimbursement policies, but also a need for more interoperable telehealth solutions that can be accessed through electronic health record or electronic medical record systems, as well as a better understanding about what types of telehealth options are available,” said Jason Krantz (above), CEO, Definitive Healthcare, in the outpatient telehealth survey news release. (Photo copyright: Definitive Healthcare.)

The increase in telehealth use at hospitals—as well as its increased adoption by physician offices—may provide clinical laboratories with opportunities to assist telehealth doctors with lab test use and ordering. By engaging in telehealth technology, such as two-way video between physicians, pathologists also may be able to help with the accuracy of diagnoses and timely and effective patient care.

—Donna Marie Pocius

Related Information:

Definitive Healthcare Survey: Inpatient Telehealth Adoption on the Rise

Definitive Healthcare Survey: 2019 Outpatient Telehealth Adoption Remains Flat

Telehealth Use Jumps at Inpatient Settings

Telehealth Use Jumps at Inpatient Facilities While Outpatient Adoption Remains Flat: Survey

Inpatient Telehealth Adoption Surges

Comparing and Contrasting Outpatient and Inpatient Providers’ Use of TelehealthMedicare: Coverage of Telehealth

Why Radiology Giants Siemens and General Electric Want to Integrate Imaging and In Vitro Diagnostics

During the past 12 months, Siemens and General Electric each invested several billion dollars to acquire in vitro diagnostic (IVD) companies. Snatched up by Siemens were Diagnostic Products Corp. and Bayer Diagnostics. General Electric has signed an agreement to purchase Abbott Laboratories Diagnostics in a deal expected to close within the next month.

By acquiring major IVD companies, both Siemens and General Electric have sent an unmistakable message. It is their expectation that the future of diagnostic medicine lies in the effective integration of imaging and in vitro diagnostics. Since both radiology and laboratory medicine generate scads of data, in recent years each company has acquired a vendor selling laboratory information systems (LIS). In the case of Siemens, it was Shared Medical Systems (SMS). General Electric acquired Triple G Systems. Further, both companies own EMR (electronic medical record) systems designed for use by office-based physicians.

Dark Daily believes it is not a coincidence that Siemens and General Electric are building almost identical capabilities to offer services that include imaging, IVD, software to handle data from imaging and laboratory testing, along with EMR and practice management software for office-based physicians. In classic economics, this is a strategy of horizontal integration. Wikipedia describes horizontal integration as “a strategy used by a business or corporation that seeks to sell a type of product in numerous markets.”

By that definition, Siemens and General Electric are building the components needed to provide diagnostic services to all segments of the healthcare market. Their goal is to integrate in vivo and in vitro diagnostics. They are assembling products that will be used by radiologists and pathologists to evaluate the patient and provide a diagnosis. This information will then be made available to referring clinicians and other relevant parts of the healthcare system.

So far, both Siemens and General Electric have offered few details about how their vision of integrated diagnostics will alter laboratory medicine as we know it today. That will change on Friday, May 10, 2007. On that day, Dave Hickey, Vice President of Strategic Marketing and Planning for Siemens Medical Solutions Diagnostics, will make a major speech at the Executive War College on Laboratory and Pathology Management. He will discuss “Full Service Diagnostics: The Coming Convergence of Imaging, Informatics, and In Vitro Diagnostics (IVD).”

Lab directors and pathologists have an opportunity to be first to learn why and how Siemens intends to integrate imaging, in vitro diagnostics, and healthcare informatics to provide clinicians with a full diagnostic report. Dark Daily considers it of particular interest that Siemens has talked about integrating these technologies in such a way as to allow physicians to diagnose disease when the patient is pre-symptomatic.

And if diagnosing patients who are pre-symptomatic isn’t radical enough, think about the implications of integrating radiology services with anatomic pathology! Traditionally, these are two medical specialties which have carefully guarded their scope of practice. Now two of healthcare’s largest companies are both committing billions of dollars to foster integration of radiology and pathology. These are reasons why Dave Hickey’s presentation at the upcoming Executive War College will provide useful insight and help guide strategic planning at pathology groups across the country.

You can get more details about Dave Hickey, his presentation, and the full Executive War College program at Make your plans now to see and hear Dave Hickey discuss how Siemens intends to integrate radiology and laboratory testing so you can prepare your laboratory for upcoming changes.
PS: To get the latest news and effective strategies dealing with new trends, join us in Miami on May 10-11, 2007 for the 12th Annual Executive War College. You can access the full details using the links below. Take action today to reserve your place.

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