Intermountain Healthcare is launching a new "virtual hospital" to speed dual aims of transitioning to digital health and tackling population health issues, but it's not ready to put the hospital industry out of business just yet.
"My guess is that hospitals aren’t going to be irrelevant for a very long time," CEO Dr. Marc Harrison told Healthcare Dive in an interview.
Still, he envisions inpatient facilities could be repurposed for outpatient services while high-performing organizations that demonstrate quality and cost-effectiveness could become destinations for patients or payers seeking value.
The Utah-based system with 22 hospitals also this month launched Alluceo, an independent company offering services based on Mental Health Integration (MHI) built by Intermountain primary care clinicians. The MHI program prioritizes physical and mental health equally, integrating mental and behavioral health services as a routine part of primary medical care.
Both the telehealth services and the Alluceo spinout echo efforts across the U.S. care system. For example, NewYork-Presbyterian CEO Steven Corwin has said telehealth services will be more important for the industry moving forward. UPMC has piloted interventional behavioral health services through Lantern, a company UPMC Enterprises invested in. A recent Foley & Lardner's survey found 75% of healthcare organizations offer or plan to offer telemedicine services. More than 80% of respondents hadn't expected their patients to using such services by this time.
Telehealth initiatives often need an education component to promote the service to both physicians and patients. Its benefits and use cases are seen as a way to help bring down healthcare costs. If adoption becomes mainstream, the idea of healthcare facilities and now many hospital buildings are needed in the U.S. could be upended.
At the same time, Harrison concedes he is being careful about new builds, where they are located, the size for which kinds of patients are targeted.
"I’m optimistic that our beautiful bricks-and-mortar backbone will not only not be irrelevant but will be very well-used," he said.
The integrated health system late last month announced it was pulling together 35 telehealth programs and more than 500 clinicians to launch its "virtual hospital." The bundle of services — called Intermountain Connect Care Pro — provides basic medical care as well as services such as stroke evaluation, mental health counseling, intensive care and newborn critical care.
The effort is part of a larger reorganization effort for the company.
"We’ve recognized there are two fundamental businesses we need to be in," Harrison said. The first is a specialty acute care hospital-based business.
The second involves restructuring outpatient access. Harrison says Intermountain is shifting to deliver more team-based care. The effort is meant to help deliver services to keep patients well and keep healthcare costs down. He calls the move a "fundamental change."
When Harrison joined Intermountain as CEO in 2016, he outlined three strategic priorities including digital health, population health management and precision medicine.
Harrison hopes the future of healthcare will see systems proliferate toward "true payer-provider models" that address social determinants of health and keep patients in the least restrictive, most effective environments to receive care.
A big part of these priorities is the virtual hospital.
Intermountain currently provides about a quarter of a million virtual consultations annually, whether it's directly to patients or via third-party hospitals. In the middle of flu season, the system saw well over 1,000 patients virtually in the month of January, potentially preventing the spread of viruses as well as emergency room or urgent care center visits.
It's an example that shows how telehealth visits can fit into a distributed network of services for both hospitals and patients to fit their individual needs.
"What we think is important is to organize a structure that makes sense to the consumer whether it's another hospital or a patient," Harrison said. "This is going to be [important] work as we create a digital front door that puts us on par with others on an enterprise approach."
Harrison noted anecdotally the system has found that some rural cancer patients have forgone chemotherapy because they didn't want to drive into a city. Putting in place a tele-oncology program has allowed patients to engage with their treatment plans at a hospital close to their home.
The system has seen an uptick in clinical services and is rolling out a tele-hospitalist care line to complement its virtual intensive care work.
"I think this is a wave of the future," Harrison said, adding many rural hospitals are on rocky financials currently but that virtual services could make them more robust and able to be more economically viable over a long period of time.