Retaining Value While Increasing Volume

By David Brown, CEO and Founder, VOX Telehealth

More isn’t always better. An increase in volume can break any system if not prepared. Take public transportation: when more people use the system, delays, crowds, and cancelations become the norm. The transportation industry, both public and private, is able to adapt by increasing the number of trips, adding staff, and streamlining processes to increase flow. Unfortunately, it’s not as easy to adapt in healthcare.

When patient volume increases, providers can add staff, add or shift rooms to accommodate more beds, and implement end-to-end process improvement tools to address bottlenecks in operating room services. But, unlike other industries, in healthcare the job is not over. Unlike the transportation industry, healthcare providers are still on the hook once a patient leaves the premises.

As healthcare transitions to value-based care and reimbursement moves to bundled payments, coordinated care must extend not only through the procedure, but through the entire episode of care. When volume increases, delivering quality care prior to, during, and after a procedure, becomes increasingly complex and challenging.

It’s a challenge that the hip and knee replacement market is currently facing. Growth of total joint replacements is on the rise, and it has been for some time. Between 1993 and 2009, total hip replacements doubled and total knee replacement surgeries more than tripled. Currently, more than 700,000 knee replacements and more than 300,000 hip replacements are performed in the U.S. annually, and demand for these procedures is expected to surge in the coming years, accounting for more than four million procedures by 2030.

Advancements in care have helped to manage this influx of joint replacement patients. The surgeries, which previously required multiple days spent in a hospital, followed by time in a rehab facility, are now performed in outpatient facilities in addition to hospitals. And regardless of setting, many patients are now going home the same day as the procedure.

While one can argue that recovering at home is advantageous for the patient, the time spent monitoring, educating, and coordinating their care becomes limited. In addition, with increasing demand, physicians will be forced to move quickly from one procedure to the next to keep up, which begs the question: who becomes the quarterback for the patient’s care?

All too often a patient has a successful surgery, only to go home and fall off track with their recovery. They fail to complete the proper exercises, follow post-discharge guidelines, or communicate questions or concerns to their provider. Patients should be accountable for their care, but ultimately, the responsibility falls back on the providers.

With less time to interact in-person, programs need to be implemented to manage the patient both in their pre and post-acute care phases remotely. Technology offers a solution. Telehealth programs can streamline processes to ensure patients have information needed for a successful outcome. Further, these solutions can assist in providing patients with action steps to aid in recovery, alerts to ensure compliance, and messaging to stay connected with their physician and care team throughout their entire episode of care.

By utilizing telehealth, it is possible for ‘more’ to be better. As volume increases and in-person time with the patient decreases, providing quality care must extend beyond the facility’s walls. In order to maintain this high quality of care, providers need to continue to coordinate and manage their patient’s recovery via technology.