Establishing a successful Telehealth Service


Establishing a Successful Telehealth Service Line

Understanding the steps necessary for a telehealth service line includes understanding how these tools can improve your practice. How can telemedicine technology help patients, providers, and the communities they serve? What are the steps necessary for a clinical team to design their own successful telehealth service line?


Understanding Telehealth’s Niche in Your Practice

Nationally, the move to embrace telehealth technology is based largely on care convenience for patients and cost-cutting for healthcare providers. Ultimately, the use of this technology varies depending on a variety of organizational factors such as the patient population, type of illness targeted for treatment via the virtual visit, and even by stakeholder buy-in for these new tools. This means one of the best steps a practice can take to understand telehealth’s unique niche requires an analysis of telehealth’s value proposition for your unique situation.


It should be noted that telemedicine is not an appropriate approach for every visit. The truth is that some clinical visits should still require the traditional office visit. However, there is a plethora of data showing telehealth’s efficacy for care delivery in clinical settings from oncology and orthopedics to behavioral health and internal medicine. Establishing a successful telehealth service line requires an understanding of how these tools can be leveraged to reap maximum benefit, including:

●       Expanding new markets and improving access to care. For practices seeking competitive market share advantage, telehealth offers a way to reach new potential markets. This also benefits patients by improving their access to treatment. A new study shows that the healthcare sector has the worst travel and wait times for an appointment of any business type. Telehealth can alleviate the time and cost of travel for patients as well as increase their access to care.

●       Reducing ER visits and hospitalizations. Telehealth can help reduce costly emergency room visits and improve patient compliance that can lead to costly hospital readmission penalties. These tools are useful for remote patient monitoring to improve outcomes. One study showed remote patient monitoring for chronic conditions could potentially save $197 billion nationally over 25-years.

●       Care continuity and coordination. Having a tool to bring together multi-disciplinary and dispersed teams is valuable, particularly in healthcare. Telehealth can serve to facilitate communication between primary and specialty providers within a single episode of treatment, consolidating data into one patient-centric approach.


Once a clinical care team understands telehealth’s value proposition, the organization should work to build a sustainable program to leverages these tools.


Understanding Telehealth’s Three Engagement Channels

One of the most frustrating propositions for telehealth adoption is that despite more than three decades of data showing ROI on these tools, providers, and patients are still slow to adopt them. Modern Healthcare states:
But many healthcare providers and administrators are not eager to upend their standard model for care delivery, which likely has been in place for decades. As a result, only a fraction of hospitals and health systems have adopted telemedicine, which in the coming years could cause them to lose patients to the burgeoning market of convenient-care options.


EY published a report suggesting that telehealth offers three ways to engage consumers, providers, and the community with telemedicine technology. These channels are an overlapping and mutually beneficial way to engage end users in new ways. EY suggests:
Telehealth programs are more likely to succeed when they integrate appropriate services across channels to build multi-faceted relationships with patients, referring physicians and health system partners.


Those three channels include:

●       Clinical services for patients can include remote monitoring of chronic diseases that feed data into an EMR. That data can help push population health initiatives to improve the health of communities, which is the second channel

●       Communities benefit from telehealth through cost-savings, faster access to care for residents, and improved outcomes. A healthier resident population benefits the entire community.

●       Providers can use telehealth for e-consults, which is the transmission of prerecorded videos or digital images. Care providers can collaborate no matter their geographic location. The obvious benefit for patients is better care coordination, but communities also benefit when local patients do not have to migrate to receive care.


Telehealth tools are a cost-effective way to provide treatment to patients struggling with access to timely care. All of these channels come together at the intersection of telehealth technology and traditional infrastructures such as electronic medical records (EMRs) or hospital billing platforms. They can also link to population-health management databases designed to harness the data captured via the virtual visit and use it to improve care quality.


Understanding the benefits of telehealth and how the delivery channels interact are step one and two toward developing a successful digital service line. Finally, providers must develop a systematic way to create a scalable and financially viable telehealth program. The next section will review the key initiatives that must be undertaken to achieve this goal.


Designing the Telehealth Service Line

The first step toward designing the telehealth service line is to understand the market realities of the service you’re offering. This should include an analysis of:

●       Macro trends such as the size of the market you’re targeting, your competitors, and reimbursement.

●       Technology including vendor research, their integration with your current technology, and data security.

●       The customer market to include the disease modalities you’ll treat, geographic barriers, demographics, and payer mix.


Providers should then strategize telehealth’s unique value proposition specific to their target audience and their practice. We recommend:

●       Conducting a community needs assessment to match the service with gaps in care coverage or patient demand. How will your telehealth program solve problems both for clinical teams and the patients they care for?

●       Understanding organizational alignment of mission, vision, and values with the telehealth service offering.


In designing your telehealth offering, there are some crucial recommendations that we have seen work well for other practices. For example:

●       Establish governance of the program. This is important whether it’s a solo practice or a large hospital-owned or private network. Also, have a plan for champion the program across your organization.

●       Plan for reimbursement by establishing the type of payments accepted, whether all-cash or private/public payer. There are also grants available to establish telehealth service lines.

●       Create standardized, repeatable workflows to promote the service, deliver care, and seek reimbursement.

●       Understand the technology and how you plan to use it, whether as a patient portal, a virtual video visit, store-and-forward, a mobile app, remote monitoring, or some other service. Is the telehealth application interoperable with your EMR or other platforms?


Finally, training and benchmarking will be just as important to your telehealth service line as marketing the service. This should include:

●       Creating a training plan for providers and a help desk for patients.

●       Measuring and improving the service line will ensure the successful testing, launch, and continuous improvement of your telehealth offering.


OrthoLive has a comprehensive telehealth service offering for orthopedic practices and hospitals. We have an experienced team standing by to help your practice and patients reap the benefits of telehealth. To learn more, contact us today.

Implant selection requires some flexibility in orthopedics

As we try to standardize implant selection and force surgeons into a round hole, it will be harder and harder to select implants based on our clinical judgment. There are no other monolithic implants on the market that allow me to “straddle” this old ACL screw and avoid having to remove it. This is a Monolithic uncemented implant w arguably the most potential for the longest survivorship. If this implant is not “on contract” then I would have to argue and argue and email and email until i get the implant approved to use. Part of the trade off as health care transitions from the old model where I could use anything and everything whenever I want at whatever price. Patient is approx 8 y out from this tka and was approx 50yo at the time of surgery.

vinod's post tka.jpg

American Innovation and Opportunity!

Ziptek’s ZipE® is a resorbable locking suture button-a knotless tissue repair system, and works like a Zip-Tie. The company is entering its 2nd year of commercialization.

Many people may be unaware that the southwest coast of Florida is becoming a hub for medical device companies, especially orthopedic devices.

Arthrex, located in Naples Florida, with nearly 1200 employees, over a billion per year in revenue, 9700 different types of devices, and whose devices are being implanted in more than 50 countries worldwide- started from a very small one device implant moving to Florida in 1995. With respect to soft tissue repair for orthopedic indications Arthrex is the top player globally.

Other very respected companies include Catalyst Orthopedics in Naples, Conmed in Largo, Parcus in Sarasota and Exactech in Gainesville, not to mention numerous Orthobiologic companies.

Ziptek LLC, a Sarasota based (and born) Medical device company founded by William F Bennett MD, a practicing orthopedic surgeon since 1995 in Sarasota, with privileges at SMH and Lakewood Ranch was incorporated in 2012. Dr Bennett came up with the idea in 1995 when operating at Doctors Hospital when he was trying to develop a technique that could address a certain pathology in the shoulder- arthroscopically- that to date was unaddressed.

From his efforts the “Bennett”” biceps subluxation classification was developed- see Radiopedia. He then went on to try to develop a device that could address this pathology, ultimately developing a device which could be used for all tissue repair and went away after time.

Starting with the commercialization process in 2010, Dr Bennett with Ziptek and his biomedical engineers received FDA clearance from the FDA in March of 2017. He and the company received over 24 IFUs- Indications for use.

Ziptek makes the ZipE®, which is a resorbable locking suture button that works like a Zip-Tie. All devices in this domain for orthopedics soft tissue repair use permanent suture and the suture fixation is permanent, meaning it never releases. This approach for tissue repair, typically ends up with scar repair and disorganized collagen.

The ZipE® which is knotless, no need for surgeon to tie knots, releases its hold on the tissue after 3 months, thus the first device to allow for the transfer of forces to the tissue allowing for true tissue remodeling allowing for the repair tissue to approach native tendon or ligament.

The Future is Now

At ProcedureCard, we don’t wait for the future, we build it. 

We have created paperless surgical preference cards. It’s a really big deal.

Here’s our story:

It started like every other day in surgery. The ritual of prepping, draping and the timeout. Today was different. We started our day using ProcedureCard.  The music station was set to Classic Rock. The nice steady beep of heart rate monitor. 

The surgical technologist deftly handed the 15 blade to me. The nurse was charting. She never had to leave the operating room. Her focus was the patient. She looked up and instinctively changed the empty IV bag. I incised the transverse carpal ligament and then started to close. Humming to my favorite band, dressings on, even the cradle boot was ready to elevate the operative extremity. 

This is how smoothly every case should go. And it can with ProcedureCard. From carpal tunnel to revision arthroplasty surgery, we’ve got you covered.

At ProcedureCard, we have built a cloud-based surgical preference card management system. Access it on any device 24/7. Cards can be easily updated and shared with the team.

Finally, reliable and accurate surgical preference cards for every case.

Have a better day in surgery with our easy to use and affordable software. Save time, save money and improve your bottom line…patient care.

Accessible. Accurate. Simple.  – Schedule a demo now –

L.R. Williamson, MD

Orthopaedic Surgeon

Consumers want Mobile Health

It’s a bold statement to say that the future of orthopedics lies in mobile health.

But the data shows an irrevocable link between technology and the future state of medical practice in the United States. That’s not just because our culture is obsessed with the digital universe, it’s because your patients will soon be demanding the convenience of telemedicine and mobile health applications.

Consumers Want Mobile Health Convenience

Telehealth is a promising opportunity to increase member engagement because a greater number of individuals are open to the use of telehealth services. Telehealth and remote care provide an exceptional customer experience opportunity for payers. Consumers want telehealth as a convenient way to receive checkups, preventive care, and non-critical services without the need for travel and wait times. HealthPayer IntelligenceMay 16, 2018

A study cited by mHealth Intelligence suggests that patients are willing, the technology is ready, but clinical providers and insurance payers have lagged behind the data that shows patients are ready for the convenience found in mobile health applications. Of the 400 consumers surveyed, 77% said they would be more likely to pick a doctor that offered telemedicine applications over one that hadn’t yet adopted the technology. The data showed the reasons behind the interest in mobile health virtual visits included:

  • Patients want the option of skipping a time-consuming trip to the doctor for a simple recheck or non-urgent visit.

  • Short wait times and the convenience of receiving a virtual house call are very attractive to patients.

When combined with the data showing that telehealth reduces costs in the medical practice, it seems clear that there are new options in the healthcare field that may improve the bottom line.

Keeping the Customer Satisfied -- Mobile Health in the Orthopedic Practice

“This direct link between patient satisfaction and revenue will likely become stronger because the U.S. Department of Health and Human Services has set a goal of linking 90% of Medicare payments to quality or value by 2018.”Beckers Hospital CFO Report

While many orthopedic providers continue to express their concern that patients will not be willing to evolve from traditional visits, the most recent research does not hold up this assumption. A 2017 Advisory Board study of patient attitudes toward the virtual visits shows that 77% would be willing to at least try the model.

The Accenture study highlighted what patients say are the primary benefits of telehealth:

  • Faster diagnosis and treatment.

  • Reduced costs.

  • Providing and receiving high-quality care.

  • More flexibility in scheduling.

  • A time savings for physicians and doctors.

A 2018 article in The New England Journal of Medicine suggests that the current model of traditional in-patient visits will eventually be flipped to the visit of last-resort over mobile health or telehealth options. The authors suggest:

Face-to-face interactions will certainly always have a central role in health care, and many patients prefer to see their physician in person. But a system focused on high-quality nonvisit care would work better for many others — and quite possibly for physicians as well.

Some of the systems leading the way are Kaiser Permanente, with 52% of their 100 million + patient encounters each year conducted as virtual visits. But a large health system has the budget to establish telehealth applications while retraining clinical providers and their patients on best practices for using the service. How can a small medical practice find the time and energy to reinvent itself under a mobile health framework?

The answer may lie in the individual practice seeking innovative ways to obtain a competitive advantage. An article by a solo-orthopedist in the American Academy of Orthopaedic Surgeons AAOS Now recounted his experience in using telehealth applications to treat post-operative patients. His decision to use the technology was tied to improved patient experience, lower overheads, and higher quality of care.

Is it time for your practice to discuss the opportunities to offer mobile health as an option for your patients? OrthoLive has developed a cloud-based affordable telehealth model designed specifically for the orthopedic practitioner. Contact us to find out more.