The pandemic drove telehealth use to new heights. Even though usage appears to be stabilizing, healthcare stakeholders largely agree that telehealth is here to stay, and they are making virtual care a vital part of their care delivery model.
Polls conducted by the American Medical Association show that 80 percent of physicians said they were using telehealth tools in 2022, up from 28 percent in 2019 and only 14 percent in 2016. Further, in 2022, about 75 percent of physicians said being able to offer remote care was an important reason to use digital health tools, up from 60 percent in 2016.
From the patient perspective, the benefits of telehealth, such as improved healthcare quality and patient experience, have become increasingly apparent.
Epic conducted a research study analyzing 35 million telehealth visits between March 1, 2020, and May 31, 2022. They found that "in nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow-up appointment in that specialty in the next three months."
Only two of the 31 specialties — fertility and obstetrics — saw in-person follow-up rates above 50 percent, while genetics, nutrition, endocrinology, and mental health/psychiatry had in-person follow-up rates of 15 percent or less.
But, as telehealth is integrated alongside in-person care, provider organizations must ensure they are selecting the right platform for their facility's unique needs and implementing them in a way that addresses — rather than adds to — clinician workflow challenges.
KEY TELEHEALTH CAPABILITIES TO IMPROVE PROVIDER WORKFLOWS
Amid the rapid rise in the adoption and use of telehealth during the pandemic, providers have faced several challenges in setting up telehealth programs.
One of the most significant difficulties is related to the technology available, notes Eric Thrailkill, Venture Partner, Founder of the Telehealth Academy, and Chairman of Project Healthcare at the Nashville Entrepreneur Center.
"While these solutions 'worked' per se, they were not designed to help health systems facilitate a hybrid care model with a goal to provide personalized care, regardless of location," he says. "During the shutdowns, almost all provider organizations were completely dedicated to supporting COVID-related patients and/or working through the backlog of previously scheduled appointments. Telehealth, due to the relaxation of certain federal and state regulatory requirements, consisted of phone-based services and two-way video technologies — speed to deploy was the operating mantra."
Provider organizations succeeded in rapidly deploying new technologies, but they did not have time to optimize their workflows to account for certain processes — like documentation and revenue cycle — and support overarching population health and chronic care goals.
During the pandemic, 'offering telehealth' could simply mean offering a two-way video solution. But now, with a couple of years of experience and data to pull from, providers are able to build robust telehealth programs to pair with in-person care. In short, a telehealth program looks at creating both a personal and efficient experience for the provider and patient before, during, and after the visit. Two-way video technology is just one piece of the puzzle.
"Telehealth platforms should contain a virtual triage where location and assignment of a provider could occur," Thrailkill says. "This would also enable an appropriate assessment to ensure higher acuity visits are prioritized over lower acuity visits."
For effective triage, relevant care teams must be able to easily coordinate their team and the patients in the virtual waiting room, chat with the patient ahead of, during, and post-visit, access the appointment, and interact with the patients while accurately documenting the encounter in their EHR and scheduling follow-up appointments. The digital experience should be smooth and the UI/UX strong to support adoption and satisfaction. Anything captured by the telehealth platform, say an image or an attachment, must have bidirectional clinical data flows enabled with the EHR to ensure the complete patient picture is captured for the patient's health record and billing and reporting purposes.
Additionally, Thrailkill notes that as provider organizations become increasingly focused on addressing social determinants of health needs, they should consider telehealth platforms that can ingest data from multiple sources. Having this data at their fingertips at the point of care can help clinicians provide wraparound care services, including connecting patients with social services and community resources.
Not only is a platform's ability to gather data from various sources essential to the success of hybrid care models, but so is seamless data exchange, which helps ensure continuity of care.
"Continuity of care is the set of processes whereby the patient and his/her physician-led care team are involved and cooperating over time to achieve the highest level of quality of care," Thrailkill says. "This is difficult, if not impossible, given the fragmentation and healthcare data silos that exist today — both outside and inside provider organizations and health systems."
Thus, telehealth platforms should have integration capabilities that provide clinicians with data from prior visits and information from facilities outside the organization where the patient has received care.
But Thrailkill also cautions that providers should keep in mind patient rights regarding consent, privacy, and security when developing hybrid care models that leverage telehealth.
IMPROVING WORKFLOWS ENHANCES PROVIDER SATISFACTION
Selecting the right platform can help healthcare organizations optimize provider workflows, thereby boosting provider adoption and satisfaction.
Providers at every level want to practice at "the top of their license," that is, utilize the highest level of their education and experience to deliver care, Thrailkill notes. For physicians, the health system's most expensive clinician, tasks like documentation and prior authorization processes can get in the way of this goal.
Prior authorization, in particular, is a critical pain point, as some healthcare payers have complex processes that require much time and effort.
"All of these administrative burdens are no doubt contributing to workforce challenges present today across essentially every professional level," Thrailkill says. But by using telehealth platforms with integration capabilities and Fast Healthcare Interoperability Resources (FHIR)-based application programming interface structures, provider organizations can reduce administrative burdens like prior authorization processes through automation and enable them to lean on their medical assistants during the triage process of the telehealth visit. This increases the time available for patient care and optimizes capacity for the clinical team, he adds.
Further, when implementing telehealth into hybrid care models, healthcare organizations should take a long-term view rather than regard telemedicine as a replacement for in-person care.
"This will challenge the organization to think about the role of medical assistants, nurses, and specialty consult providers — not as follow-on activity, but incorporated into the visit," Thrailkill says. "This will ultimately lead to operational efficiencies and reduce the amount of administrative burden existing in early deployments of telehealth."
As noted above, reducing administrative burdens and improving care delivery processes can lead to higher provider satisfaction, engagement levels, and adoption of virtual care across the health system.
Incorporating telehealth is not a passing phase, and demand will likely grow in the years ahead. But to ensure its success, provider organizations must select technology that enhances provider workflows, thereby improving satisfaction and adoption.