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5/30/2014
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Telemedicine's Appeal Grows For Employers, Individuals

The ability to virtually connect patients and physicians is shaking up healthcare and dialing up a host of new opportunities.

disrupted, what is the job to be done and am I doing it?"

Out with the old
Thomas Jefferson University and Jefferson Health Systems were successfully treating patients and educating the next generation of healthcare professionals, but board members realized complacency was their biggest foe. Wanting to run toward an opportunity rather than from danger, they recruited Dr. Stephen Klasko to disrupt their effective model and shake up the status quo.

Telemedicine's ability to reduce wait times, bring care to remote areas, enhance physicians' efficiency, remove costs, and improve patient satisfaction is now reshaping how the 190-year-old organization operates. Under Klasko's steerage, the academic organization will launch an ambitious series of telemedicine-focused initiatives this fall.

"The difference between us and other folks tinkering with this is it's at the keystone of our strategy," said Klasko, who joined Jefferson in September 2013.

This strategy includes virtual rounds -- to begin in September, whereby patients' family members can participate in meetings with healthcare providers to deliver clearer communications about treatment and post-release care. In addition, the referring doctor can hear discharge instructions, Klasko said. Post-discharge monitoring, which allows the provider to monitor a patient’s progress remotely after release, enables a patient to be more comfortable at home with the security of continued medical oversight, he said.

"A good part of readmissions are based on a lack of communications in the handoff," said Klasko, noting clarification and monitoring should reduce readmissions, improve outcomes, and enhance patient satisfaction.

Jefferson also will debut a mobile health initiative, allowing patients to see a doctor via smartphone or computer, he said.

"Health is all we do and anything that's important to health in the next 10 years we ought to be doing," Klasko said. "If I can arrange a trip to Italy on kayak while I talk to you, I should be able to arrange an appointment with a gastroenterologist. We're going to be the place anyone can access healthcare the way they want to access it. If you still want to call and wait and get an appointment, you can do that, but you're also going to be able to get an appointment from an iPhone."

Next fiscal year, the organization plans a Virtual ER -- "its real Holy Grail" -- to save patients time and a lot of money, in an age of increasing ER deductibles, Klasko said. In addition to the much larger co-pay, tests and treatments cost more at an ER than at a clinic or physician's office, he said. So if patients don't need emergency treatment, they can choose alternate -- less costly -- care.

In addition to its extensive investment in telehealth, Jefferson uses mathematical modeling and medical analytics to reduce uncertainty in medicine, said Klasko. By looking outside healthcare and seeing how other markets -- such as sports and finance -- use analytics, healthcare organizations should see the potential big data provides, he said. "As much as people talk about big data we haven't really gone outside healthcare to talk about the modeling and data," said Klasko. "It would be nice for patients to know, with my disorder, what are my chances of getting out of hospital or going to hospice? I don't think anyone should make that decision for them, but they have the right to know."

An avowed admirer of Steve Jobs, Klasko recommended healthcare leaders look beyond their organization's history and turn to external experts for guidance and suggestions. Through Jefferson Startup Health, the organization now includes a heavy entrepreneurial focus; it also requires students to take several weeks of art study in order to learn observation, Klasko said.

"You'll be able to advance at Jefferson in entrepreneurial ways," he said.

Has meeting regulatory requirements gone from high priority to the only priority for healthcare IT? Read Health IT Priorities: No Breathing Room, an InformationWeek Healthcare digital issue.

Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Alison_Diana
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Alison_Diana,
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5/30/2014 | 11:08:32 AM
Re: Disruption Ahead
Another challenge: Some people in leadership positions may not be in these positions within 10 years because they plan to leave. Do they really want to tackle these big, disruptive issues -- issues that will probably cause a lot of headaches, people to leave, and many sleepless nights -- when they can ride the tide until retirement in five, six years? It's certainly understandable that they want to leave on a current high note rather than deal with the unexpected... This is where a strong, innovative board should come into play.
David F. Carr
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David F. Carr,
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5/30/2014 | 10:54:10 AM
Re: Disruption Ahead
That's the Innovator's Dilemma - established organizations are often full of people who see the change coming, but all the incentives are aligned against change, and they get to watch others execute on their own best plans. 
Alison_Diana
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Alison_Diana,
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5/30/2014 | 9:36:37 AM
Disruption Ahead
Can you think of ways in which your organization or other healthcare organizations are disrupting established models to prepare for the changes in healthcare? As Dr. Klasko told me, when you ask healthcare leaders whether they expect their organizations to be totally different 10 years from now, they all say yes. But when you ask whether they are DOING anything differently this year or next year, the answer is NO. That leaves them eight years to totally transform their organization, often times organizations that are very large and very complex. 
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