Key business model principles for tele consultations

In order to make sure that the incentives for providing and requesting teleconsultations for both expert providers, small groups, large organizations, hospitals, clinics and individuals are aligned and in support of the deployment issues, here are some thoughts..

Responsibility for costs and outcomes

Expertise Provider (specialist, et al)

• Buy the PC/laptops, remote camera and any software needed on them, put your logo on them, and have them setup (I can help you do this, it is easy) exactly the way it wil
• help you get the work done. The receiving institution, if they already HAVE this obviously wont need you to provide it, but assume that they DONT and modify cost of service if you also are providing the tools
• Contract with whatever technicians/care managers, etc who MIGHT be needed in remote site IF the remote site does not already provide the same, or able to certify their competence
• Pay for the “find me” communication services that makes it easy to “find, schedule and get hold of the right expert”–this stuff will amount to less than $100 a month for the entire group and probably many more, so no one should balk at that given the payoff
• Determine the rates you will be charging for readings, and consultations and whether there is a direct pay component (i strongly urge this) or just relying on traditional insurance reimbursement (i am not terribly interested in this latter model, it retains all the same antiquated dependence on non-functioning industry)

What this does is defines the business model that puts the expert provider in command of whatever they need to enable other people to access their expertise virtually. But the expert and/or group has to really, really want to move to this type of model and see its potential broadly. Because if that is the case, it is not going to let any aspect of the project with any one hospital be dragged down by someone else’s challenges around technology, etc. The expert provider DEFINES the business

Hospital or other organization “requesting expertise”

• Open Internet connections so that standard, inexpensive tools used by remote expert can be leverage with NO dependence on local IT resources
• Imaging and other expensive capital devices, local physical plant resources, etc
• Set aside of operational dollars, supported by foundations where feasible, but not required—so that there is a fund to DIRECTLY pay any provider of expert telehealth and not have these projects
• depend on external reimbursement in order to get launched
• Appropriate nurse/care manager support person to help initiate the request for consultation
• Internal compensation or support for those (ER docs, OB docs, etc) who we WANT to be requesting remote expertise, making it easy as possible for them to do so, in terms of time, people, communication, etc