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Congratulations! Your institution has considered the countless benefits of offering a Remote Second Opinion (RSO) program, such as improved patient access and increased geographic reach. Your team is undoubtedly ready to jump into planning out the best program for your patients and providers. While it can be easy and exciting to visualize your RSO program helping patients, the process of getting to your go-live date can feel overwhelming. Your team may be asking big-picture questions such as:

“How do I start a Remote Second Opinion program?”
“What stakeholders need to be involved in the RSO implementation process?”
“How long will the implementation of my RSO program take?” 

A few weeks ago, the American Telemedicine Association (ATA) held their annual conference in San Antonio, Texas. The show floor was filled with impressive futuristic devices from augmented reality glasses, to home health monitoring technologies, big data products, and more. Executives from Microsoft and Google, Kim Swafford and Bakul Patel, took the stage together, kicking off the weekend with exciting updates and reminders of helpful features that emerged from the pandemic era, such as YouTube’s improved searchability, now including personal stories to help people learn about health conditions.  When asked ‘what’s next?,’ panelists joked about the potential for ChatGPT, Kim learning about it from her teenager, but both ultimately settled on describing the buzzword of the weekend, ‘omnichannel.’ 

In an earlier post, we discussed asynchronous modalities from the patient’s perspective, which also provides an introduction to asynchronous modalities:

By design, asynchronous modalities, also called ‘store-and-forward,’ sacrifice real-time, in-person communication between a patient and their medical team for remote asynchronous (not in real-time) communication. There are many positive reasons as to why both the patient and the provider would agree to, and even prefer such an arrangement. There are similarly many reasons as to why asynchronous modalities are inappropriate for handling certain cases. 
Read the entire article: Why Asynchronous Part 1; How Patients Benefit

This article will focus on the benefits asynchronous modalities can offer providers and their physicians.

Access for Patients
Asynchronous modalities open access to patients outside of a provider’s primary service area. For second opinion programs, patients are typically making the request due to navigating an especially rare or complex health issue. These patients often do not have the same caliber of expertise in their local area, or are not getting the results they want. Asynchronous modalities connect the patient, and often the referring physician as well, to experts with deep specialties in their particular condition or disease. Access to specialty care is a great need for millions of Americans, asynchronous solutions take a step towards providing equitable access.

Strategic Growth for New Revenue Sources
More than three years following the start of the pandemic, a lot has happened, but it seems that everyone can agree on one thing - healthcare as we know it has changed. Definitive Health reports that 76% of hospitals have implemented some form of telehealth, a 42% increase from 2019. In our earlier post, we discussed the rising demand and preferences of patients for telehealth modalities for access, cost and convenience, driving providers and payers to meet demand.

By design, asynchronous modalities, also called ‘store-and-forward,’ sacrifice real-time, in-person communication between a patient and their medical team for remote asynchronous (not in real-time) communication. There are many positive reasons as to why both the patient and the provider would agree to, and even prefer such an arrangement.

Demand for telehealth solutions has boomed over the past few years. Medicare telehealth visits alone grew from 840,000 in 2019 to 52.7 million in 2020, or 63-fold as shown right (source: Benesch Friedlander Coplan & Aronoff).

For cases deemed appropriate for telehealth, some studies have provided overwhelming evidence of increased patient satisfaction with remote visits compared to traditional in-person (urology; breast cancer; radiation oncology; general medicine). One of the main drivers? Convenience. Patients love removing the travel time and associated costs or tradeoffs that come with taking off work, finding childcare, and traveling to see a physician in person. Additionally, the CDC reports that 15%, or 49.8 million Americans live in rural parts of the U.S., which correlates with poorer health outcomes regardless of income level. Access to specialty carefor this population has been known to be especially difficult or impossible, but telehealth programs have introduced a new channel that many patients can take advantage of. 

In addition to increasing patient demand, there is a strong business case for Hospitals to expand their reach through telehealth modalities. A recent article by Purview's Dr. Christopher Schwartz, Remote Second Opinions: A Cure for the C-Suite Blues, describes the challenging financial state of many hospitals post-covid. Schwartz explains that, ‘during the lockdown alone, U.S. hospitalslost an estimated $22 billion in revenue due to cancellations in elective surgeries.’  Contrast this with the estimated value and market growth of the second opinion market at $10.7 billion by 2027with a CAGR 16.8%, and it is understandable why many hospitals are exploring the potential of these programs. Here, we outline key considerations for your organization as you assess readiness prior to launching a second opinion program.