By Dr. Alan Roga, President, Provider Market, Teladoc
Telehealth’s successful track record with patients is well documented, with between 94 and 99 percent of telehealth patients reporting being satisfied with their telehealth services, and a third preferring the experience to a traditional in-person visit.[i] Telehealth has also proven to be popular with physicians, which is important because physician engagement is an essential element for a telehealth program to succeed. In fact, earning physician support was the top lesson learned by hospital and health system executives that have created telehealth programs.[ii] Those leaders also said physician satisfaction is the second-most important element of a successful telehealth program, behind only patient satisfaction.
There is a lot to learn from successful program leaders. While some organizations have found physician engagement an obstacle, most have successfully resolved any concerns by engaging physicians relatively early for planning and communication about how the telehealth program will be developed, positioned and supported.
The keys to earning physician support for telehealth are to involve physicians early in the program planning process and to address their main concerns around quality, time commitments and competitive threats. Educating physicians on the merits of telehealth, including quality, oversight and outcomes data; and showing how telehealth can not only be good for the health system, but also for patients and for the physician’s own practice, have all been shown to be successful in garnering their support.
Early Involvement Builds Engagement
When telehealth is first being considered, physicians should be included in planning discussions to provide clinical input on process improvement, quality and program goals. They should also have an ongoing role in the program. While this may appear intuitive, this often gets overlooked, as evidenced by the fact that 54 percent of hospitals and health systems that have telehealth programs do not measure physician satisfaction.[iii]
Validate and Address Concerns
Most of the worries that physicians express about becoming involved in telehealth programs relate to two areas: workload and quality. Highlighting the benefits of practice flexibility and voluntary participation from a core group of physicians has been shown to be a successful approach to mitigating these concerns.
Telehealth requires physicians to work differently, but does not necessarily require them to do more work. Telehealth is an outstanding option for physicians who desire an alternative to traditional practice. For example, it has been very popular with physicians who have disabilities or temporary medical conditions; those who care for their children, elderly relatives or other loved ones; others who desire the flexibility to work from home; and physicians considering retirement who want to scale back, but not give up practice completely. Health systems have found telehealth provides a helpful recruitment and retention tool to attract physicians who desire practice flexibility.
There have already been millions of telehealth consults performed and many health care providers have documented excellent clinical results from their telehealth programs. Concerns about the quality of care, especially regarding vendor telehealth provider networks, can be effectively countered with insight into the clinical and operational processes that have evolved in telehealth. High quality standards and evidence-based protocols have been developed and are built into solutions. In fact, through technology many telehealth programs are able to standardize treatment and have greater physician oversight than traditional brick-and-mortar delivery models. Quality assurance programs that include board oversight on operational metrics, literature review, prescribing rates, satisfaction and chart review all are typically present in programs. External credentialing entities, including NCQA and The Joint Commission, have evaluated programs and provide further quality insights.
Demonstrate Value to Physicians
Alongside workload and quality, health system physicians can also see telehealth as a threat to their practice. In fact, the opposite is often the case.
Telehealth can extend their practice capabilities and efficiency. Vendor networks can support health system physicians by providing access to care on nights, weekends, holidays and other times when physicians aren’t available. As opposed to other retail models, telehealth encourages patient retention through referral mechanisms that refer patients back to the primary physician, and by supporting exchange of electronic health records. Finally, through its consumer-facing aspects, telehealth provides a gateway for new patient acquisition and referrals into participating practices.
Some physicians see telehealth as a threat. Resistance usually fades quickly when physicians are engaged early in the process, learn about the quality outcomes, understand the practical applications and have continued involvement in the program going forward. By communicating these potential benefits to physicians, and engaging them in planning, you can create a telehealth program that successfully meets the needs of your organization, your physicians and your patients.
[i] Polinski JM, Barker T, Gagliano N, Sussman A, Brennan TA, Shrank WH “Patients' Satisfaction with and Preference for Telehealth Visits” J Gen Intern Med. 2016 Mar;31(3):269-75. doi: 10.1007/s11606-015-3489-x. Epub 2015 Aug 13.
[ii] Teladoc “Hospital & Health Systems 2016 Consumer Telehealth Benchmark Survey” It is available at https://www.teladoc.com/materials/resource/2016-consumer-telehealth-survey-results