20 years ago TiVo turned the television industry on its head. Appointment TV was shaken to the core when we were empowered to time-shift our favorite shows. Rather than rushing to see our primetime favorite and sitting rooted for an hour or more, we could watch at our own time, blithely forwarding through the advertiser’s hustle.
Our communication methods alternate between synchronous — live chat (video or otherwise) — to asynchronous (mail, videos, social media) means. Similarly, our consumption of content and services too alternate — as from live broadcasts to streaming on-demand.
I had wondered when health services will see a similar time-shifting that TiVo did for TV.
I am not wondering any more! No, not just because of Covid-19 even though Covid will accelerate this trend towards asynchronous care, leveraging many telemedicine policy changes and practical realities of care delivery during this crisis.
The combination of place-shifting and time-shifting in care delivery should unleash innovations to improve access to care and lower costs.
First, a brief look at place-shifting in healthcare over the years.
Place-shifted Healthcare: Synchronous, Varied Settings
Cost considerations and needs based on our condition drive the choice of the place-of-care. Below is a quick look at a samplingof facilities and bed-level services deployed in care delivery.
In the last decade, more services are being delivered in outpatient settings than before. Even complex surgeries like hip and knee joint replacements have found acceptance in ambulatory/outpatient settings, driven by clinical innovations and cost control efforts.
Care-at-home and telehealth are on the rise too, resulting from quicker discharges to home, older population needing care at home, and better technology.
However, all these changes in care settings did not change the live, synchronous nature of care delivery between the care provider and us. Every interaction remained live, by appointment — much like our pre-TiVo appointment TV experience.
Why can’t the health system look at my physiological data and tell me at a sane hour what I should do about it? Do all that analysis offline and tell me after I wake up, please?
Time-shifted Healthcare — Asynchronous, Always-On
Enter care delivery a la TiVo!
Slowly and steadily our health policies have been shifting towards telemedicine in various forms. The efforts got a thrust due to Covid-19 emergency. Remotely managing patients while not requiring line-of-sight or synchronous communication between clinicians and patients is one such shift.
Remote Patient Monitoring (RPM) services that include virtual check-ins and e-visits as defined by Medicare are examples of asynchronous care delivery.
TiVo-Care is time-shifted healthcare.
Asynchronous care is time-shifted, distance-agnostic, borderless, and agnostic of the location of the recipient and provider.
It is a great way to improve access to care and drive better use of precious clinician resources in scenarios where time-sensitive care is not needed. Clinicians get to stay connected with patients and take timely action as needed. Reimbursements from private insurers and Medicare is starting to accelerate adoption of these services by providers.
We will see many more care innovations in our lifetime — beyond complex same-day-discharges, beyond remote surgeries, beyond novel ways of extending care in communities.
Augmenting synchronous care with asynchronous care is a significant step to empower patients in our healthcare innovation journey.
Originally published at https://www.linkedin.com.
