Women’s leadership roles increasing in Telehealth & Health Care, but the journey toward equity is far from over

Charlotte Yeh

When Charlotte Yeh entered medical school decades ago, it was the first year more than 10 percent of the slots were available to women. Fast forward to today, and women make up almost half of medical school classes. Women also hold prominent roles throughout health care, including in management. But getting a coveted spot in the C-suite has been tougher, says Yeh, now the chief medical officer for AARP Services.

“Women are not very well represented in the highest levels of leadership,” she says. “The current generation may feel kind of complacent… but they haven’t realized there’s still the hurdle of getting into the top management.”

That broader picture is similar in the field of telehealth, where women leaders say they’re still underrepresented. So how can women strengthen their roles in telehealth as the industry continues its explosive growth? In a first-ever event, the American Telemedicine Association conference in Orlando this month will feature the panel, “Women Executives in Telehealth: Positioning for the Future.”

“I’m very impressed with the ATA,” says Yeh, who will moderate the panel. “It’s remarkable and a positive sign of the times that they’re already talking about leadership.”

In the best, most high-performing organizations in any field, Yeh says, it’s common to see more women included among the board and management. “Let’s face it, men and women are different,” she says. “Women may lend a very different lens or perspective versus if everyone at the table looks the same.”

Mon PM, Kristi Henderson

Kristi Henderson

That’s especially true in health care, as women often make decisions related to their family’s health, says panelist Kristi Henderson, vice president for virtual care and innovation at Seton Healthcare Family. “Without their voice,” she says, “solutions will not appreciate the perspective of women who are the users or facilitators of these services the majority of the time.”

Mon PM, Julie Hall-Barrow

Julie Hall-Barrow

In telehealth specifically, it’s imperative for women to play a role in the direction and innovation of new technologies and how organizations and companies are structuring their strategy, says panelist Julie Hall-Barrow, vice president for virtual health and innovation at Children’s Health, Dallas. “Without the perspective and tenacity of women in key leadership roles,” she says, “the industry as a whole will lack vision.”

Progress made, but more needed

The enormous growth of the health care industry in the last two decades has included increased options for women, says Henderson, who began exploring telehealth 18 years ago and went live with her first telehealth program in 2003. “The number and variety of jobs in telehealth have created new opportunities for women across business, clinical and technology sectors,” she says. “The value of women in health IT leadership roles is evident, resulting in increased numbers of women holding senior leadership roles in telehealth, health systems and health IT in general.”

Hall-Barrow, whose work in telehealth was spurred in the early 1990s, says she’s witnessed a growth of women leaders in the market. “My career has followed this trend,” she says, “and has led to incredible opportunities to lead efforts in one of the largest states in the nation and in one of the leading pediatric health care systems in North Texas.”

Mon PM, Paula Guy

Paula Guy

But while companies are putting policies in place to achieve equality for women in the workplace, more work is needed to create neutral gender environments, says panelist Paula Guy, president and chief executive of Salus Health.

There remains an underrepresentation of women at the board table, Henderson says. “There has been a slow increase of these women moving into more senior positions and being invited to the table for decisions,” she says. “Now that there is more of a conscious attention to diversity and inclusivity, this underrepresentation is changing.”

There’s still room for women leaders in telehealth, particularly in the C-suite and boardroom, says Hall-Barrow, and current leaders should encourage this by mentoring other women.

Advice from top women in telehealth

Honing an expertise to differentiate yourself from the pack is one way to achieve success in telehealth, Henderson says. “Find your skill and passion, then refine and perfect that skill,” she says. “Determination, integrity and tenacity are critical factors for career advancement.”

Start with a win, Hall-Barrow says. “When putting a program together, creating a technology, or implementing a system, do so with a guaranteed success,” she says. “This success will drive leaders to pay attention to your work and seek your advice for the next opportunity.”

Find a mentor, especially one in the field, Hall-Barrow says. “The more you can learn about the industry,” she says, “the faster you will make an impact in areas that you aren’t expected to make.”

And keep up with the rapidly changing health care market. “The more you know, the more key you will be in your industry,” she says.

Women have a long way to go to be close to where men are in leadership positions in health care, including telemedicine, Guy says. “The women I know in telemedicine are smart, strong, passionate, caring, and they work hard to get the job done,” she says. “If given the opportunity for leadership positions, we would see telemedicine grow like never before.”

Here’s how telehealth tools help hearing health professionals improve patient care

New technology is constantly being developed to improve our ability to diagnose, treat, and care for a variety of medical conditions. One up-and-coming technology trend is telehealth. Some of the telehealth tools that we have already seen include services that enable video conferencing between doctors and patients, and apps that assist in patient care. In the field of hearing care, such tools also improve healthcare delivery for both patients and service providers.

TeleHealth tools save time for professionals and patients

It is common practice in hearing care to bundle the cost of consultations and service provision into the price of the hearing aid.  As such, follow-up and fine-tuning appointments after hearing aid sales are often free of charge. Dedicated telehealth tools like texting apps offer a secure platform for patients and hearing care professionals (HCPs) to easily communicate and problem-solve in a few minutes without an office visit.  Hearing telehealth apps can even allow HCPs to remotely adjust the hearing aids’ settings.  This is convenient for the patient, but also saves the HCP valuable appointment time.

Telehealth apps can also contain simple instructional videos, FAQs, and troubleshooting guides so that patients have the information readily available to them on their smartphone. This way, they can often easily solve their problems before contacting the HCP and feel empowered with greater confidence in their new hearing experience.

Telehealth apps help hearing care professionals widen their reach

Telehealth apps can bring patients and HCPs closer than ever before.  With a reduced number of necessary in-office appointments eliminated by in-app messaging and calls, and remote hearing aid tuning features, HCPs can attract patients who live physically farther away, and are therefore less inclined to make repeated trips to the office. Similarly, they can provide services to less mobile patients who may be house-bound or live in care facilities.

Telehealth enables patient satisfaction monitoring

Patients buying new hearing aids typically have a two- to four-week home trial period before making the final purchase decision. Patient satisfaction during this time is crucial to the ultimate adoption of hearing aids. Unfortunately, this is also typically a “blind spot” for HCPs, because with the patient out of their office, they are not physically present to answer question and provide guidance when problems arise.

Telehealth apps for hearing aids allow wearers to rate their daily satisfaction. Apps can assign various listening activities for the patient to complete, such as “have dinner at a noisy restaurant” or “listen to music”, and then ask the patient to rate their satisfaction with the hearing aids in those situations.  Satisfaction ratings are sent to HCP via the app, so that the latter can actively intervene to address patient concerns in a timely manner without waiting until the next follow-up appointment.

Telehealth apps serve as a practice differentiator

The hearing care industry is a competitive field. Patients can choose from independent hearing care practices, those affiliated with physicians, hearing aid dispensing chains, “big box” wholesale stores, or even bypass the HCP altogether and choosing an amplification product online or “off the shelf.”

One of the ways a hearing care professional can stand out from the crowd is by offering exceptional service. With in-app text and call features, telehealth apps promise potential patients access to the hearing care professional’s expertise and guidance even outside of regular office hours, the convenience of fewer in-office visits, and in-app usage and troubleshooting information.  These advantages can be promoted as a part of the “white glove service” that HCPs can leverage to promote their practice.

Telehealth tools are good for business

Telehealth tools can help HCPs generate revenue in more than one way.  First of all, time is money. By reducing the number of follow-up visits, telehealth apps help free up more time for professionals to attend to revenue-generating tasks, such as diagnostics or new patient fittings. And the increasing number of younger, tech-savvy, and smartphone-dependent patients with hearing loss will be attracted to HCPs who offer conveniences like telehealth apps.

Ultimately, patient satisfaction leads to business success. By being able to monitor patient satisfaction with their new hearing aids during their home trial period, and intervene quickly when problems and doubts arise, professionals can use telehealth apps to minimize barriers that otherwise result in hearing aid returns.

Although there are smartphone apps now that help us with almost every aspect of our lives, telehealth tools that use such technology are still relatively new to the hearing care profession. As they become increasingly powerful and popular, we can expect them to bring even more benefits to patients and hearing care professionals in the future.

Photo: IAN HOOTON, Getty Images

Jefferson Health taps Teladoc for telehealth needs

Purchase, New York-based Teladoc is making moves in the telehealth space.

Jefferson Health in Philadelphia recently went live on Teladoc’s telehealth platform.

What prompted Jefferson Health to handpick Teladoc as opposed to another vendor? “Many of the other vendors were not designed the way Teladoc was,” Dr. Judd Hollander, the associate dean for strategic health initiatives at Thomas Jefferson University’s Sidney Kimmel Medical College, told MedCity in a phone interview. Instead, it was designed with health systems in mind, he pointed out. “The advantage is they have a platform that does what we need to do,” Hollander said.

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Dr. Alan Roga, president of Teladoc’s provider market, echoed that sentiment. “We understand the unique needs of hospitals and health systems and have developed a purpose-built telehealth solution specifically for them,” he said in a statement.

The Teladoc system is now part of Jefferson Health’s existing telehealth program, JeffConnect. But the new go-live doesn’t mean JeffConnect has disintegrated.

“JeffConnect still exists. It’s the brand of our program,” Hollander said. “We’ve changed nothing about JeffConnect. We’ve added the Teladoc platform, which is branded as JeffConnect, to that.”

JeffConnect, which includes inpatient care, outpatient care and transitions in care, enables patients to connect with physicians via phone, computer or tablet. Using JeffConnect, patients can see a physician in a variety of different ways. They can connect with their physicians 24/7 through on-demand visits. Patients can also schedule video visits or use the remote second opinion option to get additional thoughts on their care.

Whereas other hospitals and health systems outsource some of their telehealth visits to other providers, Jefferson Health does not. That’s what sets JeffConnect apart — patients always see a Jefferson Health physician, Hollander said. “That’s really unique about JeffConnect,” he said. “We believe our patients want to know that when you call Jefferson, you get Jefferson. We’re able to do that on this platform.”

And JeffConnect’s services aren’t limited to a certain physician specialty. “If you have an appointment, you can have it with every type of specialty at Jefferson,” Hollander said.

Though the price of a JeffConnect visit varies depending on one’s insurer, an on-demand visit currently costs $49.

Working with Teladoc and improving its JeffConnect platform aren’t the only things Jefferson Health is doing in the telehealth field. For one, it’s developing the National Academic Center for Telehealth, a hub focused on the intersection of technology and healthcare. Jefferson Health is also training medical students and residents in telehealth.

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Carbon Health launches virtual clinic to create network of independent physician practices (updated)

Virtual visit interaction via Carbon Health app

This post has been updated with comments from Carbon Health CEO Eren Bali  

The technology entrepreneur who founded Udemy, a marketplace for online courses, is looking to make a big splash in the world of healthcare with the launch of Carbon Health. The San Francisco-based healthcare startup led by Eren Bali raised $6.5 million in its first institutional round led by early stage investor Builders VC, according to a company press release.

Other investors that took part in Carbon Health’s inaugural round included Javelin Venture Partners, Two Sigma Ventures, and Bullpen Capital which invests in companies at the post-seed funding stage. Angel investors in the business include Elad Gil — the cofounder of Color Genomics, and Russ Fradin, the CEO and cofounder of Dynamic Signal who served the board of Udemy for four years. Another is Aaron Patzer, who founded Mint.com, invested in HealthTap, and has a care coordination startup of his own in New Zeland.

Carbon Health gives patients virtual access to their providers and allows them to schedule appointments, make payments, fill prescriptions, and access medical through the app, according to the release. Although the approach seems pretty similar to HealthTap, TreatMD, Zipnosis, GrandRounds and other telehealth providers, many of which are also working to integrate labs,  insurance companies, pharmacies, and medical imaging centers, Bali claimed in a phone interview that Carbon Health’s approach differs in critical ways.

He said Carbon offers a more comprehensive service than rivals. He also predicted that most patients who would opt to use its app would have a primary care physician that’s part of Carbon’s network. Although individuals can use the service to ask questions about insurance and medications, they would only be charged if they had a virtual visit with a doctor or were recommended to come in for an appointment.

Bali founded Carbon Health with cofounders Tom Berry and Dr. Greg Burrell.

The investment will enable Carbon Health to advance its business beyond the pilot stage and expand its platform to independent healthcare practices across the country. Bali added that the company plans to expand from Northern to Southern California by the end of the year with independent practices that cover a total of 100,000 patients.

It’s an open question how much money these services actually save. Although one study seemed to indicate telehealth did little to reduce healthcare costs, another focusing on diabetes retinopathy showed how this technology can make a big difference.

Photos: Carbon Health

What are the effects of telemedicine in a safety net setting?

How well does telemedicine work in a safety net healthcare setting? Pretty well, it turns out.

A new study in JAMA Internal Medicine analyzed the effect of a teleretinal diabetic retinopathy screening program on both screening wait times and screening rates in the Los Angeles County Department of Health Services.

The LAC DHS, which serves underinsured and uninsured patients, is “the largest publicly operated county safety net health care system in the United States,” the study points out. It serves more than 800,000 patients each year.

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Diabetic retinopathy, the top cause of working-age adult blindness in the United States, impacts more than 5.3 million Americans, according to a study in The Lancet. And it isn’t rare in the Los Angeles area — a study in Ophthalmology found the prevalence of DR among diabetic Latinos ages 40 and up in Los Angeles was just under 50 percent. The JAMA Internal Medicine study also notes that the retinal exam wait times for newly diagnosed diabetes patients in LAC DHS have been at least eight months, if not longer.

As part of the study, researchers implemented a teleretinal DR screening program in 15 LAC DHS safety net clinics. They trained medical professionals as fundus photographers to use cameras in primary care settings and take pictures of patients’ eyes. The pictures were then uploaded to a database and analyzed by a team of LAC DHS-employed optometrists, who also gave recommendations for follow-up.

The survey results are based on information from five of the clinics. Approximately 21,222 patients went through the screening process.

After implementing the program, the researchers found that the average screening rate increased from 40.6 percent of patients prior to implementation to 56.9 percent of patients after the program was implemented. Additionally, they uncovered the average wait time to have a screening decreased by 89.2 percent (158 days pre-program to 17 days post-implementation). The researchers also found that 14,595 of the patients did not need to be referred to an eye care professional after the screening, thereby eliminating a large need for extra specialty care professionals.

“The safety net is ideal for telehealth interventions owing to limited resources and high disease burden; these interventions allow for health care professionals to work at the top of their skill set, which in turn increases access to care,” the researchers concluded. “We believe that the U.S. safety net would be wise to invest in telehealth programs such as this one to address critical needs regarding access to care.”

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UPMC Health Plan telemedicine platform gives patients 24/7 access to care

UPMC seeks to give patients on-demand, high-quality care through UPMC AnywhereCare.

The ever-changing field of telemedicine: 3 experts weigh in

How can the healthcare industry deal with the supply and demand of resources in telemedicine? Where does the cost fall for all the change happening in the world of telecare? What will be the next disruption of technology to support telemedicine?

These are just a few of the questions a group of experts sought to answer during a panel discussion at the Pepperdine Graziadio Future of Healthcare Symposium on March 23. Titled “Advances in Telemedicine for the 21st Century,” the panel brought together three individuals: Hill Ferguson, CEO of Doctor on Demand; Samir Malik, senior vice president and general manager of Genoa Telepsychiatry; and Lou Silverman, CEO of Advanced ICU Care.

The panelists’ companies are at the forefront of technology innovation in healthcare. Doctor on Demand, a telemedicine company, offers patients medical and mental health services. Genoa Telepsychiatry, which is part of Genoa, a QoL Healthcare company, works to expand access to mental health services. Malik came to the company through Genoa’s acquisition of his startup, 1DocWay. Advanced ICU Care implements and oversees tele-ICU programs throughout the country.

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Despite the convenience of telemedicine, there’s a growing need to address the supply and demand of resources in the field. “We are delivering expertise broadly to many markets for perspective,” said Silverman. “Typically our physicians are licensed in north of 20 states. We do all of that ourselves. We will credential them at many dozen hospitals, and that is so that we can solve that access problem that many hospitals face.”

Malik added that there are other ways telemedicine can “help move the needle on supply.” For one, he noted many of the providers who work with his company practice telemedicine in addition to their full-time position, thereby increasing the supply. However, the problem won’t be solved overnight. “Unless you can find a way to grow a doctor tree or a nurse practitioner tree, you’re not really going to solve the supply issue,” Malik said. “But on the edges, we can try to expand the box we’re in.”

Another discussion point revolved around cost and its impact. Ferguson noted that for Doctor on Demand, the two largest beneficiaries of cost savings are the consumer and the payer. “A typical visit cost for our customer is about half of what they’d pay if they went to a Walgreens or CVS MinuteClinic and about 30 to 40 percent of what they’d pay if they went into an urgent care clinic,” he said.

Technology is changing every day and will more than likely alter the face of telemedicine in the years to come. What exactly does the future hold for healthcare technology? Ferguson pointed to changes in innovation on the hardware side, such as enabling small devices to have greater computing power.

Silverman, however, said Advanced ICU Care is practicing “relentless incrementalism” rather than focusing on a potential “big bang innovations.” Similarly, Malik noted that the implementation of innovations like artificial intelligence and virtual reality are still far off in the future. “The truth is, those technologies are so far out right now that the applications, much less the business models, can’t really be distilled,” he said. “There’s a lot of room to run on this runway before we even start thinking about things like artificial intelligence.”

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Mobile follow-up care can prevent in-person visits after surgery

Hate it or love it, telehealth is undoubtedly on the rise. As technology is implemented in the healthcare field, many have questioned whether telehealth services are truly effective in treating patients.

A new study in JAMA Surgery found that ambulatory surgery patients who used a mobile app for a post-surgery exam were less likely than those who didn’t to make an in-person follow-up visit.

The study was conducted among 65 female participants between February 1 and August 31, 2015. The women had all undergone breast reconstruction surgery at at Women’s College Hospital in Toronto, Ontario, Canada.

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The patients were randomly assigned to one of two groups. The 32 women in the first group utilized a mobile app to receive follow-up care during the first 30 days after surgery. The 33 women in the second group received follow-up care via a traditional in-person visit in the first 30 days post-surgery.

The results? Patients in the first group (the mobile app group) attended an average of 0.66 in-person follow-up visits during the first month after surgery, while patients in the second group (the in-person group) attended an average of 1.64 in-person visits. Patients in the first group also sent more emails (0.65 on average compared to 0.15 for patients in the second group) to their healthcare providers during the first month after surgery.

Patients in the first group also reported higher care convenience scores than those in the second group. In fact, 31 patients (97 percent) in the first group either agreed or strongly agreed that the type of follow-up care they received was convenient. In the second group, only 16 patients (48 percent) agreed or strongly agreed that the type of care they received was convenient.

There was not a significant difference in the number of telephone calls patients in each group made to their providers. During the first month after surgery, patients in the mobile app group made an average of 0.30 calls, compared to an average of 0.31 calls for patients in the in-person group. There also was not a notable difference in the complication rates or satisfaction scores of patients in either group.

“Patients undergoing ambulatory breast reconstruction can use follow-up care via a mobile app to avert in-person follow-up visits during the first 30 days after the operation,” the study concluded. “Mobile app follow-up care affects neither complication rates nor patient-reported satisfaction scores, but it improves patient-reported convenience scores.”

Although the JAMA Surgery study boasts the positive results of telehealth, a recent RAND Corporation study wasn’t as positive. The RAND study, which came out in early March, found that direct-to-consumer telehealth services could drive up medical spending because they often initiate the use of new medical services.

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