Table I.

Advantages, disadvantages, and unintended consequences of a regional telehealth platform

Advantages

•Expansion of connected health to more population groups •Co-location of required support staff (ie, information technology, credentialing, schedulers, nurse call center, etc) •Allergists embedded within larger organizational structure •Improved position to adapt to ever-changing regulations •Centralized efforts and strategy •Improved communication between regional medical center specialties and originating site locations •Increased involvement with Graduate Medical Education and telehealth training •Focused on “value” aspects of telehealth (eg, emergency department visits, readmission rates, drug allergy evaluation, and reduced carbon footprint) •Reduced time from referral to specialty visit

Disadvantages

•Significant start-up costs (eg, staff, peripheral carts, and peripheral medical devices) •Success requires strong C-suite support and specialty “champions” •Initial efforts may focus on one specialty over another •Provider reluctancy to use telehealth (“late adopters”) •Initial efforts can wither without sustained financial investment and staffing •Underuse of originating site(s) without dedicated full-time equivalent assets

Unintended consequences

•Information technology aspects (eg, patient portals and internet connectivity) may be a barrier for patients with limited connectivity •Telehealth support assets may not increase with increased provider visits •Increased telehealth appointments may result in increased need for “in-person” visits, which may be a preexisting geographic barrier for rural and remote patients •Increased telehealth may reduce clinical or laboratory visits with local community providers •Increased work for health care and information technology teams at originating sites