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The American Telemedicine Association's 18th Annual International Meeting & Trade Show kicked off with a flourish on Sunday in Austin, Texas – a flourish of bagpipes.
ATA President Stewart Ferguson, chief information officer of the Alaska Native Tribal Health Consortium in Anchorage, Alaska, took the stage of the opening plenary decked out in a Scottish kilt and sporran.
It was his contribution, Ferguson joked, to the unofficial motto of the conference's host city: "Keep Austin Weird"
But there was nothing weird or at all surprising about the news he had to relay.
Even though hurdles related to reimbursement and licensure continue to be thorny issues for remote care delivery, said Ferguson, these days "we pretty much know how to do telemedicine."
Now, he said, "the challenge is how to do it at scale."
[See also: Heading to Austin for ATA? 10 popular attractions.]
The ATA has spent the past year working to drive adoption of telemedicine, create consumer awareness and prepare for rapid change as these new care models are embraced, said Ferguson.
That change is well on its way: consider the fact that in 2012 some 30 states introduced telemedicine related bills.
To make the most of it, Ferguson said there's been focused efforts to strengthen ATA. The past year has seen a 20 percent increase in annual revenue and a 36 percent growth in staff. This year's meeting and trade show is the biggest yet.
Indeed, as ATA Vice President Yulun Wang, chairman and CEO of InTouch Health, announced, it's been "another record growth year," with attendance at the 2013 show surpassing 5,000 people – who will attend more than 500 educational sessions, covering every facet of telemedicine – for the first time ever.
A 'mainstay' of care delivery
The plenary keynote speaker, Lynn Britton, president and CEO of Chesterfield, Mo.-based Mercy, offered some object lessons on the enormous impact telemedicine is starting to have on the way care is delivered.
Mercy, one of the largest Catholic healthcare systems in the U.S. – with urban and rural facilities across Missouri, Kansas, Oklahoma and Arkansas – has some things to teach about incorporating telemedicine into a large network.
In 2012 Mercy cared for more than 3 million individuals, Britton pointed out – but only a few hundred thousand of those spent the night in the hospital.
That's thanks to its trailblazing $90 million Virtual Care Center, which has pioneered initiatives such as virtual ICU, remote pediatric cardiology, telestroke, telepsychiatry and more.
Care must be delivered on a "local, regional and virtual" basis – all three at the same time – to be truly effective, said Britton.
The Virtual Care Center is proof that that ethos has evolved "to the point where we've reached a critical mass," he said.
The proof is plain to see. Thanks in large part to telemedicine, the length of stay in Mercy's ICUs is 30 percent below what's expected, said Britton. Its telestroke program led to more treatments with clot-busting tPA in six weeks than in the entire year before.
And its virtual care is not just for rural locations. At urban Mercy Hospital St. Louis, a 900-bed facility, a sepsis program – in which patients at risk, no matter where they are in the hospital, are aggregated virtually into one unit and monitored for immediate action once they show signs of distress – has cut mortality from septic shock in half.
For those reasons alone, that multimillion-dollar investment has been worth it, said Britton.
"If we had thought about the classic return on investment around the infrastructure we built, we would have had second thoughts about it," he said. "But the return is there, because that infrastructure is robust and sound, because we can provide those services in every one of those communities you saw on that map."
Telemedicine, said Britton, is "absolutely core to who we are, it's core to our business model. And it makes business sense."
Six years ago, he said, "We weren't reimbursed for much of what we were doing in telemedicine. Today, most of the consults are reimbursed, much of what we do in the ICU is starting to be reimbursed as well.
"It shifts entirely when you start to think about it from a population health management strategy," he added. "It becomes a necessity to be successful. As we transform the business and clinical models, I just think these things are necessities."
The technology for telemedicine is in place, and it works. Policymakers and payers are starting to see the light. Now, it's about spurring further adoption and more providers onboard.
Mercy's story shows why.
"We don't think telemedicine and virtual care is on the fringes anymore," said Britton. "It's a mainstay of what we do."