Q&A: UPMC’s Dr. Andrew Watson Lives and Breathes Telehealth
Dr. Andrew Watson believes telehealth makes him more humane and smarter at his craft.
A practicing surgeon and vice president of clinical IT transformation at the University of Pittsburgh Medical Center, Watson says the technology allows him to provide faster, safer and less burdensome care. “Why would you put someone in a car for four hours for a follow-up?” he says. “Patients feel more secure at home. Bringing care to them is part of the general humanity of medicine.”
Watson spoke about telehealth’s evolution, the misconceptions surrounding it and his tenure as president of the American Telemedicine Association’s board.
What’s been most surprising about telehealth’s evolution over the past few years?
Just how much the consumer electronics market is leading us around. There’s so much capacity with the market, it’s almost hard to recalibrate the future of telehealth without fully capturing what the consumer electronics market is going to do.
Telehealth seems to now be divided into three different areas: traditional telehealth that offers rural access to services like radiology and dermatology; direct-to-consumer care, which has been a tremendous service line for us and has been great for the patients and the doctors; and remote monitoring, which is a big part of what I do every day.
We’re seeing telehealth emerge to be sort of mutually interdependent at times, and other times it can feed channels that have a lot of potential for healthcare. I don’t think we knew this a couple years ago.
How would you say patients are reacting to using these tools? What is the learning curve?
I would say, as a whole, medical communities are surprised by how much patients actually like it. We had age bias, gender bias, technology bias, morality bias — all these thoughts that it wouldn’t work. But really, when you think about it, the estimates are that about 80 percent of people these days have a smartphone, so in terms of learning how to do telehealth, it’s not really us teaching them. It’s Apple, Google, Samsung and others that are teaching them how to do video calls, how to activate smartphones, how to text, about voice recognition. So much of the teaching has been done by the consumer electronics market.
And it’s made our lives a lot easier. We don’t have to explain to patients how to turn on a phone or how to connect it; that’s already done. Conducting a video call is not foreign to them; they’re used to doing it.
We monitor congestive heart failure, and here at UPMC, we have a couple hundred live video visits every day. The average age of participating patients is 72, and the satisfaction rate is 93 percent; 96 percent of them would recommend the program to another person.
It doesn’t surprise us because, if you’re elderly, remote monitoring really gives you the convenience of getting healthcare at home, and that’s what it’s all about.
What is the potential for telehealth in senior care?
Senior care is a tremendous opportunity to take advantage of telehealth in a variety of ways. Patients and residents at skilled nursing facilities and long-term acute care organizations often have a lot of medical issues, and to move them to the emergency room is not inconsequential. It’s hard for the patient and the family and it’s also very expensive.
We’ve started a telehealth company to support seniors in their long-term acute-care skilled nursing facilities. We also use remote monitoring technology in our hospice and for advanced illness care, which is prepalliative care.
What are the biggest misconceptions about telehealth? What about hurdles?
There are a lot of people saying that it’s not good for the patient or that it’s a lower quality of care, but I don’t believe those things have played out. Another misconception that we as an industry have to do better at debunking is this perception that it’s too expensive. We need to show that telehealth is not an additive cost and that it’s actually valuable. One of the biggest hurdles is integrating the technology so that it seamlessly interacts with key healthcare systems. But the potential here is almost limitless.
What have you learned through your service with the American Telemedicine Association?
That telehealth needs to be clarified across the continuum of healthcare. It cannot just be a rural access issue.
It’s something that we at UPMC are uniquely poised to clarify, because we’re a payer-provider and in the third-most rural state but feature a complete line of care, from cradle to grave, including preventive care and well care.
Do doctors being trained today anticipate that telehealth will just be a normal part of patient care?
The physicians of tomorrow will come to practice with the expectation of telehealth. There’s no doubt. They’re seeing it in their fellowships, they’re seeing it in their practices, they’re hearing about it and they’re reading about it. It’s just a matter of time.
There’s also a bit of a carrot-and-stick dichotomy, because if you practice medicine or if you’re a payer and you don’t offer telehealth, you may suffer if other providers around you are offering it. It’s almost as if you have to play defense as well as use it for the right reasons.
What advice would you give to organizations that are just starting to explore telehealth for their own patients?
Do right by the patients, but immediately focus on the value of the business in the operational sense. There often are operational and financial hurdles that make a program impossible unless you help the patient or the system. Identify those challenges early, not late.