As discussed in our August Health Update article on patient engagement and digital health—the first in our new digital health series—the advent of digital and telehealth technologies is rapidly changing the way patients interface with health systems. The demand for telehealth services is growing dramatically, and systems that adopt telehealth solutions can achieve enhanced coordination and integration across clinical service lines. Patients are increasingly using digital tools to manage their care and relying on telehealth tools, such as video visits and remote patient monitoring, to conveniently access and monitor their care.
The adoption of telehealth technologies is critical to modern-day health system transformation efforts. To that end, health systems should carefully assess and strategically prioritize telehealth platforms that address system-specific objectives. There are a number of ways that telehealth supports system transformation, including:
- Enabling clinically integrated networks. Telehealth solutions can enable a higher degree of integration among service lines within a health system. For instance, eConsults' platforms bridge communication lines between primary care providers and specialists, allowing for rapid information sharing, the development of unified care plans and more coordinated care.
- Strengthening network development with care continuum partners. Telehealth solutions, such as virtual consults, can help link health systems with other care partners, such as long-term care facilities or behavioral health providers. For example, UPMC has implemented Project Raven, a virtual consult project that digitally connects UPMC hospitals with 15 partner nursing homes. Using videoconferencing technology, nursing homes can consult virtually with hospital staff to determine if a resident requires hospitalization. Over a three-year period, the project has yielded about $5 million in net savings, reduced potentially avoidable hospitalizations by 24% and decreased potentially avoidable emergency department visits by 41%.1
- Creating specialist capacity space efficiencies. Telehealth solutions can help ensure that patients are getting the “right care at the right time in the right place.” For example, instead of having a community primary care physician (PCP) referring a patient who may require a heart consult to a cardiologist, the PCP can request a case review from a cardiologist who can review the specific case on his or her computer and determine if that patient in fact requires specialty care. If the patient is not in need of care, the cardiologist can provide the PCP with recommendations and avoid an unnecessary office visit, which frees up both clinic space and the cardiologist’s time for more acute patients.
- Supporting consumerism strategies. Consumers are increasingly demanding and expecting on-demand services and solutions in the palms of their hands. Systems can stay ahead of consumer demands by offering mobile-based telehealth tools, such as on-demand urgent care video visits or second opinions.
The Challenges of Telehealth Adoption
Telehealth adoption is not without its challenges. Most health systems have struggled to define and deliver on large-scale telehealth program deployments. Common challenges that health systems experience include:
- Proliferation of departmental solutions or pilot projects without overarching vision and strategy
- Poor clinician adoption due to lack of integration with usual clinical workflows
- Inefficient financial incentives to scale programs
- Lack of alignment between system leaders, IT and clinical priorities
- Insufficiencies in existing technology to deliver new types of services
Successful telehealth implementation is dependent upon careful and methodical telehealth strategy development. We encourage health system leaders—including administration, clinical, operations and finance staff—to coalesce and consider what business and clinical problems they are trying to solve through telehealth; which clinical services and visit types lend themselves to telehealth models; how different telehealth models create value; how a telehealth program should be deployed, governed and organized; and what core telehealth technology platforms should be rolled out.
Finally, we believe that a systematic approach to telehealth strategy development is essential to successful telehealth adoption and implementation. The following telehealth strategy framework may be useful to health system leaders as they develop their own telehealth strategies: