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Telehealth Enabling Clinical Outsourcing
The evolution of telehealth is not only expected to reshape the delivery of consultations, monitoring and treatments it is also expected to reshape
healthcare providers' and patient/citizens' access to healthcare services. Healthcare delivery is no longer controlled and will be less and less
controlled by secondary and primary healthcare providers.
Telehealth is a new platform on which healthcare provision can be reshaped to meet the challenges of an aging population and more demanding and
discerning patients/citizens. Telehealth involves automating all routine healthcare processes, from monitoring blood sugar levels to administering
drugs, and extending the distribution of more complex and expert medical expertise, by using videoconferencing to deliver consultations or surgical
support. Following both these paths delivers benefits to healthcare provisioning, enabling medical staff to work more effectively, whatever their
level of expertise or responsibility. Telehealth provides them with a tool to eradicate mundane and low-value healthcare processes and maximise their
core skills and expertise. The same level of automation that is routine amongst financial and retail verticals for example, are not as prevalent
within the healthcare community. Changes underway have the potential to fundamentally change the delivery of healthcare in the near and long-term.
The fact that certain monitoring or diagnostic processes can be automated means that they no longer need to be managed by healthcare providers. If
a service is IT-based and does not rely on medical expertise to be processed, then a specialist company could better manage that process. The
non-clinical component of the telehealth process is no longer a core competency of healthcare providers. As a consequence healthcare could outsource
appropriate telehealth functions and it will become increasingly attractive for suppliers to develop such services. Outsourcing telehealth services
will allow healthcare providers to focus on their core skills, much the same as way as call centre/customer service outsourcing allows financial
companies to focus on their core competencies.
Philips HeartCare and AirLiquid Sanita already provide cardiac monitoring services and there is no reason why specialist service providers could
not develop other monitoring services. Services deployed by providers could be preventative and postoperative in scope, to reduce the time spent by
patients in hospital or to prevent them from needing to visit hospital. The treatment and consultation side of healthcare provision would however
remain the core focus of healthcare providers. In effect, the supplier and client are both able to focus on their core competencies where telehealth
outsourcing is concerned.
In order to understand the medical and clinical procedures and processes that healthcare providers undertake, we need to better understand the
intra and inter workflows, communications, procedures and processes amongst secondary and primary healthcare providers. This is crucial in order to
ascertain which work functions can be successfully automated and possibly outsourced. In the utilities market, for example, companies outsource their
billing and customer services processes to third parties. These processes are deemed not to be core competencies by those companies and there is no
reason why outsourcing amongst healthcare providers cannot extend beyond IT infrastructure and services to more care based IT processes.
Willingness and innovation from both healthcare providers and outsourcers is required to enable outsourcing to become a workable and cost effective
alternative to the traditional medical processes and procedures. Very few traditional outsourcing companies have the skills to deliver telehealth
services to healthcare providers, but through partnerships and alliances this may be achievable. In order for outsourcing to work the user and
end-user must be happy with this change:
· Medical professionals – willingness to lose a certain amount of control over medical processes and procedures, rely on IT
applications and adapt to new work practices
· Patients – willingness to utilise healthcare IT applications, to lose a certain amount of practitioner/clinician contact, trust
telehealth applications etc.
The provision of telehealth services, as an outsourced solution, also means healthcare providers no longer become the sole channel for healthcare
provision. Insurance companies investing in telecardiology solutions have to a great extent stimulated telecardiology services in the USA, and thus a
new channel to market has appeared for service providers. This is of benefit to healthcare providers since they no longer need to manage telehealth
solutions, and service providers not only have the ability to provide telehealth services direct to healthcare providers, or indirectly via a
different channel, but also to new customers such as insurance companies. The provision of telehealth services enables the development of new indirect
marketing channels specifically targeting the patient as end-user. Certain telehealth services could be better served via new channels and not
necessarily through healthcare providers. Involving healthcare providers builds in cost and unnecessary complexity, and they should only be involved
in a supportive capacity not as an administrative one; much in the same way insurance companies have involved telecardiology patients'
practitioners. This introduces the concept of telehealth outsourcing.
This all goes far beyond the business process outsourcing (BPO) that traditionally encompasses billing, HR, customer service functions etc. BPO is
still a relatively new concept for healthcare providers to latch onto and this new breed of Healthcare Process Outsourcing (HPO) may be one step
beyond their comprehension and their willingness to adopt such solutions. Companies such as CSC and Perot Systems provide IT outsourcing to healthcare
providers, such as payroll, HR, desktop, applications, networks etc. BPO has entered the healthcare vertical, the NHS has a contract with a consortium
led by McKesson, including IBM and PWC Consulting and Oracle, to consolidate its HR functions. This ten-year project, awarded in December 2001, is
aimed at replacing 29 different payroll and 38 different HR systems with a fully integrated payroll and HR system for one million NHS staff. In the
future the contract may also extend to adding Internet-type technologies for e-recruitment, e-learning and employee self-scheduling. There is
willingness for healthcare providers to utilise BPO services, and as this is a new concept it may still be too early for HPO to take-off in the near
future. HBS Consulting believes that telehealth HPO will emerge as a winning formula as healthcare providers face more and more challenges, forcing
them to outsource and automate basic clinical and medical services covering monitoring, information services, drug delivery, patient support etc.
Sectors likely to receive HPO focus include the elderly, pharmacy, cardiology, obesity, allergies etc. Readers should understand that not all
telehealth solutions are appropriate for HPO development. Market participants must be aware of their limitations in providing the clinical part of
telehealth solutions, and must work with healthcare providers to develop telehealth solutions that deliver a win-win situation. This would constitute
a win for market participants through the development of new revenue streams, and a win for healthcare providers through streamlining existing
administrative and monitoring processes. | 
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