By Dr. Alan Roga, President, Provider Market, Teladoc
Defibrillators, antibiotics and scalpels aren’t strategies. That’s obvious, but it doesn’t make those resources any less valuable for delivering care. Why bring this up? Because we sometimes see confusion about the role and expectations for another important care delivery tool: telehealth. About half of U.S. hospitals now have telemedicine technology in place, according to HIMSS Analytics,[i] and another survey found 76 percent of hospitals and health systems will have consumer telehealth programs in place by 2018.[ii] Many of these efforts are in their early stages, and we have spoken with many hospital and health system leaders who are unsure of where to take their telehealth programs. This article is intended to help you see telehealth’s strategic implications.
Telehealth is a tool, not a strategy. Without clarity on telehealth’s role, organizations may limit the effectiveness of their programs and the benefits telehealth can provide, which include improving access and outcomes, improving patient engagement, and reducing the cost of care. Telehealth programs are most effective when they are aligned to support organizational strategies. This is where we often find confusion.
The table below presents a sample of specific telehealth programs that can be used to support some commonly held goals hospitals and health systems are pursuing today. The listing is not comprehensive; rather it is intended to give a sense of the scope of telehealth’s potential application.
As the table suggests, telehealth can be used for services ranging from emergent care to post-discharge care. However, no single use case supports the full range of possibilities. Telehealth needs to be applied in a targeted way in programs that are crafted to address organizational capabilities and patient needs. That is why it is so important to align telehealth programs with organizational strategy. For example, a team could spend weeks developing a proposal for using telehealth to offer geriatric services to assisted living facilities in the area, only to find out geriatric health will not be an organizational focus area in the coming year. Aligning telehealth strategy with organizational strategy improves the chances of getting telehealth programs approved and helps win senior-level support. More importantly, it can complement the results achieved by the overall strategy and provide greater benefits for the entire health system.
Developing a telehealth strategy and designing supporting programs takes time and must account for many variables that are specific to the organization. There is a risk of choosing to use telehealth in a way that doesn’t support organizational goals, and there is also risk in using telehealth in ways the organization isn’t fully ready to support. When considering telehealth use cases, these risks need to be considered along with the value they can create. That requires assessing each use case’s complexity and urgency, and its clinical and administrative impacts. How to establish an effective telehealth strategy is too deep of a topic to cover here except for some fundamental guidelines:
- Identify leading organizational (not departmental) goals;
- Assess whether telehealth use cases are applicable to organizational goals;
- Conduct a formal, objective assessment of your organization’s ability to design, implement and manage telehealth programs;
- Prioritize telehealth opportunities based on use cases identified and the readiness assessment;
- Evaluate potential partners and solutions.
This approach creates a fundamental understanding of the organization’s needs, abilities and limitations. That knowledge is invaluable when it comes time to design the program and select partners and solutions. Otherwise, there is a risk of losing sight of your needs by getting distracted by the many solutions and ever-growing examples of successful programs.
The assessment is an especially important step, so organizations should commit the time and resources needed to complete a thorough appraisal. It should evaluate your IT system readiness, skills availability, ability to identify and prioritize use cases, current telehealth experience and maturity, ability to set appropriate metrics, and the key success factors and risks specific to your organization.
Getting the most value from telehealth isn’t necessarily the result of finding the best technology; it depends more on crafting a telehealth strategy that advances the overall organizational strategy. That requires general familiarity with the scope of how telehealth can be applied, and much more specific analysis of where it best fits your organization. Telehealth has proven to be a very effective tool for supporting different kinds of care. It’s a much more effective tool when it is used to build on organizational strategy.
[i] HIMSS Analytics “Essentials Brief: 2016 Telemedicine Study” April 27, 2016. Summary accessed March 23, 2017, from http://www.himssanalytics.org/news/telemedicine-adoption-growing-35-annually-2014
[ii] Becker’s Hospital Review “2016 Hospitals and Health Systems Benchmark Survey: Consumer Telehealth”