Guest Column | April 21, 2020

Telehealth: The Platform Is Burning

By Tammy Graves and Matt Henry, Point B

Telehealth Growth Problems

Leveraging your outpatient organization’s rapid implementation of telehealth for a long-term strategy to serve your patients.

The rapid launch and/or acceleration of an existing telehealth program in light of COVID-19 is a matter of survival for your healthcare organization and your patients.

For outpatient providers: Transitioning outpatient visits to virtual care is crucial in capturing revenue to keep your doors open.

For physicians and clinicians: The desire to stay healthy while serving patients is speeding up provider adoption of telehealth technology.

For patients: For patients needing to see their provider (e.g., primary care, dermatology, behavioral health, physical therapy, occupational health) but are confined to their homes or otherwise restricted by in-person options, telehealth has provided a literal lifeline.

So now what?

How can organizations move beyond the immediate crisis, and develop a sustainable telehealth growth strategy?

You can leverage your current telehealth implementation efforts as part of your long-term strategy, no matter how hastily developed. Utilizing any strategic framework, build a long-term vision and strategy that:

  1. Reduces or eliminates future rework.
  2. Aligns with your overall organizational strategy and model of care.
  3. Facilitates sustainable growth and builds long-term value for your providers and patients.
  4. Enables flexibility and agility to regulatory and reimbursement changes.

When we say any strategic framework, the point is to embrace a disciplined agility, to plan with intention and move quickly to define the desired experience, because:

When you are fighting for the economic survival of your practice, you cannot afford for your short-term investments in telehealth to be throw-away work.

Regulations on telehealth technology options have been lifted for the COVID-19 crisis. As such, many health centers have rapidly deployed telehealth with a technology in which they are comfortable. However, they may not have properly vetted the data security, workflow or scalability implications on its architecture long-term. Before committing your telehealth program to this technology, consider drawing up basic requirements for your practice, starting with simple questions:

  • Are we operationally prepared to deliver telehealth services? Consider how your telehealth technology platform will work with other tools and functional teams such as online scheduling, patient portals, EMR, revenue cycle, and patient triaging tools.
  • Are our clinical teams and professional networks prepared to support telehealth services? How will varying degrees of skill competency, capacity, physical workspace and enabling technology align to deliver a desired patient experience? Understand how these considerations, as well as solution modalities, will impact throughput and support your model of care.

Answers to these questions can provide a rapid assessment of operational needs and limitations of your providers and patient population. These insights will help you determine whether you build a strategy to utilize existing providers or transition to a strategic telehealth technology partner that is capable of managing a supplemental provider network.

Telehealth Programs Are Not A Stand-Alone Service

Executed well and designed with the outcomes in mind from the beginning, telehealth programs can be fully integrated into your model of care and overall strategy. While the rapid deployment of telehealth in many outpatient centers is focused on simply shifting high volumes of in-office visits to virtual visits, take a step back to reimagine the work. Determine what types of visits are best suited and what patient outcomes are best delivered by a telehealth option consistent with your model of care.

Telehealth includes store and forward, remote patient monitoring, mobile health platforms, and telehealth (telephonic, video, etc.) visits. How do each of these options fit into your overall strategy? The knee jerk response is one of practicality (our providers are comfortable on a phone and they all have one) and revenue (we’ll get paid HOW much more for a telehealth visit?!). Recognize that solutions and reimbursements are changing rapidly. Consider the end-to-end experience – how to effectively deliver digitized care and how patients can easily access your providers (our solution will enable a personalized experience that easily brings care to patients in need).

Once you develop a telehealth strategy for services offered and identify the preferred technology and methods for interaction, install key performance indicators to drive performance, utilization and overall adoption of the new ways of working. How does this align with your existing provider utilization and vendor capacity? Some other considerations for scaling your program include:

  • Plan and test for network connectivity and space requirements depending on modality (video, chat, etc.). This may require network and/or equipment upgrades at facilities or stipends for remote offices for providers and patients at home or other non-traditional places of work.
  • Invest in training curriculum for providers, support staff and patients. When possible, leverage providers already delivering telehealth services to help with training, building FAQs and other means of personalized learning.
  • Engage communities through marketing and outreach. This cannot be overlooked and will drive your adoption rates. Make sure the new services are communicated to and consumed by patients, common referral networks, local governing bodies, and all public-facing platforms providing current telehealth protocols.

Consider The Purpose Of Your Telehealth Program Beyond The COVID-19 Pandemic.

Translating simple revenue capture into a sustainable, long-term growth strategy can have tremendous benefits for your organization, providers, and patients. Some opportunities to keep in mind:

  • Provider burnout was an epidemic in this country before the current crisis. Many providers have found relief in the ability to continue to see patients without the added time of a commute and rooming procedures. Consider how telehealth can help you attract new sources of talent and retain top talent in the long-term.
  • Many consumers and patients have long expected that technology should be utilized more effectively in healthcare and were frustrated by the slow adoption of these tools. Having a strategic telehealth roadmap, informed by emerging technology trends and patient and provider insights, can increase your end-to-end experience and net promoter scores, enabling you to leap-frog tech-lagging competitors and align more with other digitally savvy organizations.
  • The CARES Act has provided CMS with waiver discretion for the provision of telehealth services. While the implementation of these is in direct response to the current crisis (and driving commercial plans to follow suit), there are questions about how these changes will persist once the crisis ends. The potential for national standards for telehealth such as provider flexibility to practice across state lines, expanded family practice and routine specialist reimbursement parity, more flexibility with modality of choice (meeting data privacy requirements, etc.), and in-person prior relationship requirements will be debated and may continue in the longer term.

These opportunities should be considered as you develop your post-COVID-19 telehealth strategy.

At the end of this crisis, we’re going to see a major disruption of the healthcare industry. Accordingly, there will likely be two camps of outpatient centers delivering expanded telehealth services: those who adapt to survive and those who seize the moment to transform. In which camp will you reside?

About The Authors

Tammy Graves and Matt Henry are consultants with Point B an integrated management consulting, venture investment, and real estate development firm.