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How to rebrand 'Telehealth' (guest column)

Linda Cavalli Nelson of Smith Rock Resources.

“Good-bye Telehealth, Hello Connected Care.”  Credit goes to Abraham Whaley for this catchy headline to his recent post on the Manage My Practice blog. He was writing about the Connected Care Alliance (CCA), a newly formed lobbying group chaired by former Senators Trent Lot, Tom Daschle and John Breaux. As part of its launch, CCA is rebranding telehealth as “connected care.”

Maybe telehealth hasn’t been catching on like we hoped because the name was wrong. “Health at a distance?” Not always desirable, when you think about it. But who doesn’t want their care to be connected? What’s the alternative — unconnected care? Uncaring connection? Even the telehealth naysayers are nodding their heads. We all want our care to be connected. Sign us up. Now that we’ve finally got the name right, how do we execute for success? How do we practically realize the potential of these technologies for addressing our most pressing health care issues and supporting the Triple Aim goals of “better health and better care at a better cost”?

The CCA is going after some of the obvious roadblocks by addressing the legal and regulatory issues that have limited the widespread adoption of these technologies to date — for example, licensing and reimbursement. We cheer them on. However, there are non-legislative issues that are equally important to ensuring that Connected Care becomes the home run that it could be for the Triple Aim.

I recently spent time with a group of executives seeking to advance the use of “connected care” technologies in their state. They are doing a wonderful job of building out the broadband infrastructure in rural areas, so local providers can access specialist and other urban center services for their patients. Great quality. Great user experience. It’s all great — except for the numbers. Relatively few users, and relatively low utilization rates. Definitely not a home run. Here’s the argument I made to these executives: connection, integration and coordination. First, for care to be effectively “connected,” the majority of providers and patients in a given healthcare network must be, um, connected. Sounds obvious but in my experience it is typically not the reality.

In the situation above, a rural doctor may be able to connect via secure video with a specialist in the big teaching hospital a few hundred miles away, but not with the other doctor treating his patient down the street. Not because of any technical limitation, but simply because one provider subscribes to the telehealth network and the other does not. Related patients and providers need to be connected on a common network from the start. If we wait for each user to independently join — as in the case of the State network mentioned above — the value of that network as a means of connecting care across a given system or region will be limited. So What About the “Care” Part of the Equation?

Workflow integration is arguably the single most important factor in making connected care relevant and helpful to providers. I have seen more than one telehealth project (sorry, that’s what we called them back then) fail because they weren’t integrated. So instead of connecting and enhancing the care already being provided, telehealth became just one more implementation burden for providers, and therefore just one more under-used technology. If integration is key to making connected care effective for providers, coordination is key for making it effective for patients. Online models that connect patients with random providers for an urgent care need or routine inquiry can offer great convenience and economic value.

However, they do not and cannot address many of a patient’s most important healthcare needs — for example, the management of a chronic health condition over time. They can also undermine a patient’s health to the extent that the care provided may conflict with that of an existing provider.

To serve the best interests of patients, Connected Care must therefore also be Coordinated Care – meaning that all those providing care to a given patient need to be connected and communicating.

I recently submitted a grant proposal to a regional healthcare organization for a “Coordinated Care Telehealth Access Platform” that would have done all of the above for their Medicaid population for pennies per patient per month:

Plus integrated remote monitoring management with low-cost, user-friendly devices, and mobile alerts for red flags (e.g., missed medications, a sudden weight gain, etc.). My proposal had a Triple digit ROI within the first six months. We didn’t get funded but I’m not giving up. I know the technology works. Perhaps I had the wrong name. Goodbye Telehealth. Hellooo Connected Care.

Linda Cavalli Nelson is the principal of Smith Rock Resources, LLC, which assists client and portfolio companies in monetizing their intellectual property and other assets through strategic partnerships and new product and business development. She lives in Redmond, Oregon. She can be reached at