‘Moving beyond dollars and cents’: AMA introduces telehealth framework to grasp value of telehealth

The American Medical Association teamed up with Boston-based Massachusetts General Hospital and New Orleans-based Ochsner Health System on a May report to develop a framework for measuring the value of virtual care.

As telehealth becomes more integrated into healthcare offerings, the AMA developed a virtual care foundation to guide clinicians, payers and virtual care leaders in assessing the value created for patients. The framework measures six value streams and can be a resource for other hospitals seeking to design care models.

The six value streams:

1. Clinical outcomes, quality and safety.
When virtual care is implemented effectively, it may enhance clinical outcomes for patients. Virtual care can be used to improve medication adherence, adherence to discharge instructions and disease detection. Ochsner found that medication adherence improved 14 percent over six months with virtual care, yet decreased 2 percent with usual care.

2. Access to care.
Virtual care may improve access to care and decrease the wait time to get an appointment. Mass General found that 95 percent of consultation requests in the last two years were answered within five minutes. Enrollees in Ochsner’s medication adherence program had 93 blood pressure readings recorded in the EHR on average during an undisclosed amount of time, compared to 1.6 blood pressure readings from patients who maintained normal visits during that same period.

3. Patient, family and caregiver experience.
Virtual care programs may improve the care experience for patients and their families and caregivers. Eighty-four percent of patients said they were satisfied with Ochsner’s digital medication program, compared to 72 percent of patients with usual care.

4. Clinician experience.
Virtual care has the potential to allow clinicians to connect with patients more easily. Ochsner reported that clinicians exhibited enhanced satisfaction because they were able to provide more support to their patients. It can also make their work schedule more flexible and help them connect more easily with colleagues.

5. Financial and operational effects.
Hospitals may not pursue adopting virtual care unless it’s financially beneficial. Health insurers may be reluctant to reimburse virtual care visits unless it’s cost-effective. Ochsner has contracts with several employers and payers to cover the cost of their medication adherence program. It saved each member $77, compared to what they would have paid for usual visits. 

6. Health equity.
Ochsner designed its medication adherence program with health equity in mind. The program mailed patients the devices they needed and provided patients with technical support. Mass General is not measuring equity yet, the report said.