Part III – Looking Ahead: Sustaining and scaling your telehealth program

Jason Anderson
By: Jason Anderson
Date: May 12, 2020

So, You Implemented Telemedicine. Now What?

In partnership with Sonder Health, Avaap is providing a three-part series for healthcare organizations that rapidly moved to implement a telehealth solution at the onset of COVID-19 and have since dealt with a surge of virtual visits. Make sure to catch up on Part I and Part II of the series.  

Part III – Looking Ahead: Sustaining and scaling your telehealth program

The rapid pace at which we have seen telemedicine expand has left providers and patients with a patchwork foundation and “figure it out as we go” mentality. Healthcare organizations should now look ahead and develop a plan to scale their telemedicine and broader telehealth services to take advantage of the newfound appreciation for virtual care. It is evident that telehealth is here to stay, and organizations need to prioritize this initiative moving forward. To deliver telehealth effectively, they will first need to take a step back and address some foundational principles that would normally be considered in a telehealth implementation but may have been passed over in exchange for expediency.

telehealth

Develop an enterprise telehealth approach

Healthcare providers need to determine their long-term goals for telehealth use. Establishing strong governance across service lines will be critical in developing enterprise guiding principles and standards for implementing and using telehealth. Be sure to include all the relevant stakeholders to ensure a comprehensive oversight. If your organization was quick to implement telemedicine or expanded services to respond to demand, there are a few things the governance team should focus on first to set the stage for long-term success.

Perform a telehealth services rationalization – Did different service lines create their own processes or use their own technologies to support virtual visits? Identify all the different pop-up telemedicine services to get a full picture of telehealth services at your organization. From this, the governance team can create an enterprise solution to ensure consistency for patients, providers, and shared services.

Establish KPIs and benchmarks – How will you determine which service lines provide effective care via telehealth? Key metrics should be retroactively applied to measure whether the services provided during the public health crisis were valuable and sustainable moving forward.

Identify key telehealth services – Which services can build telehealth into their standard care delivery workflow? The necessity of proving virtual care gave telehealth the opportunity to shine for certain areas, such as behavioral health and perinatal services that may not have made this transition as rapidly otherwise. Prioritize services that were cancelled that cannot be found elsewhere or are temporarily closed due to COVID-19 and include those in the go forward roadmap. All services should determine how and where any aspect of telehealth can be implemented, from pre-op screening to full visit replacement to post-op monitoring. Do not be afraid to be innovative. Telehealth has many applications and patients will soon come to expect it.

Create the infrastructure to scale

Part of telehealth services rationalization should include identifying a HIPAA-compliant platform to provide virtual visits and evaluating your ability to build on existing technology to provide fast, reliable, and high-quality experiences. Non-healthcare approved messaging or video tools may have been helpful to respond quickly, but they do not provide the most secure experience moving forward and may not be compliant currently or in the future as regulations tighten. A dedicated telemedicine platform will allow for an enterprise approach and consistent experience.

As services look for creative ways to implement telehealth, organizations should also consider other questions as they evaluate their technology capabilities to support. Will telemedicine services be provided from the clinic or hospital? From a central hub or individual provider offices? Will providers be allowed to provide care from their home? Beyond virtual visits, what devices will be needed in the hospital or available to patients to support remote monitoring?

These questions will need to be addressed to scale telehealth services while still providing quality care. The governance team should engage physician leaders from all areas to understand their needs.

Set yourself up for success

As new telehealth services are added, providers should be evaluating the full end-to-end workflow. This includes prior to the visit lifecycle itself, where physicians will need to answer questions such as when they want to make themselves available for telehealth? Do they replace normal clinic hours with virtual visit time slots, or do they offer time outside of normal hours? Could flexibility help to alleviate some of the current schedule pressures and burnout they experience, or will it exacerbate it? What type of resources and credentialing criteria needs to be in place? Organizations will need to assess their ability to deliver these services and how it will impact their physicians and staff.

The patient workflow also needs to be considered when developing a new care delivery model around telehealth. Patient adoption and ability to use new technologies will depend on a variety of factors – age, language, location, socioeconomics – and there needs to be a plan for how to support patients in scheduling, use, and adherence to telehealth services. Patients are also more likely to use the services if they can see their normal physician, highlighting the importance of collaborating with physicians on a schedule that works for them. If patients are not set up to succeed and have a good experience with telehealth, then it will not matter how good the technology is, the program will not achieve the desired results.

Promote your telehealth services

A telehealth program will also not achieve desired results if no one knows about it or how to use it. Carving out budget and investing resources to market your telehealth services is critical to success. Not just in making people aware that you offer the service, but helping them understand the value of these services, such as eliminating time spent travelling to the office and in the waiting room, potentially avoiding a more expensive urgent care or emergency room visit, and decreasing chances for developing complications post-discharge. As patients better understand the benefits, they will be more likely to adopt telehealth. Patients will also need to be aware of which services are covered and how. This is especially important now as more services are currently available under Medicare and Medicaid but will likely change in the coming months.

Organizations should also use marketing strategically to help retain and gain patients. For existing patients, the key focus should be reducing revenue leakage by better guiding referrals back to you. The telehealth services should be promoted as a part of the after-visit or discharge processes, and those services should act to replace an in person visit or to drive them back to you for follow-up care. For new patients, social determinants of health are a unique way to evaluate your market and how certain services will benefit the community. Using this data will allow for more targeted messaging rather than blanket campaigns.

We are here to help

As your organization works to transition from the recent telemedicine surge to sustained delivery of virtual care, Avaap and Sonder Health can help you navigate how to effectively expand your overall telehealth services. We are your partner through the good times and the bad, sharing a common goal of improving health care for the communities you serve and where we live. Stay safe and thanks for following us!

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