The 5 Critical Telehealth Metrics
Here are the 5 critical telehealth metrics that healthcare leaders need to pay attention to in order to ensure that their telehealth services are performing as well as they should:
1. Clinician Satisfaction
2. Patient Satisfaction
3. Technical Performance
4. Overall Visit Volume by Modality
5. Overall Reimbursement by Modality
Let’s review the nuances of these 5 critical telehealth metrics.
Service Performance Metrics
The most critical metric of all (and the one most clinics ignore) is the satisfaction of the clinicians. When we work with clients we ask the clinicians, for example, “the telehealth visit was as good as an in-person visit” and we repeatedly get 4.3 or 4.4 on a 5-point Likert scale, so high satisfaction across the board is possible.
The second metric under service performance is patient satisfaction. Typically, the acceptance of telehealth across all demographics is very high. Patients love the convenience and appreciate the efficacy with which care can be received. With our clients, we typically ask the patients “How likely are you to recommend telehealth with this provider to your friends and family?” and have gotten Net Promoter Scores (NPS) in the 70s, which is considered world-class service.
Here’s the reality: If the physicians do not like delivering care via telehealth, none of the other metrics matter much. The most prevalent root cause of statements such as “patients don’t like telehealth” is that physicians don’t like it. Even with the slickest technology and full reimbursement, if the physicians’ mindset is that telehealth is not as good as in-person care, they will find self-fulling evidence to support their sentiment.
It is therefore imperative that healthcare leaders frequently measure physician satisfaction – and then act on the data to improve satisfaction.
A powerful question we’ve started using in recent months is: “How comfortable are you offering telehealth to a patient when clinically appropriate?” While that question does not measure satisfaction directly, it gets at what we actually want: for clinicians to use telehealth when it is clinically appropriate and acceptable to the patient.
While telehealth is not about the technology (but about the workflows and managing the organizational change), it certainly is about the technology when the technology is not working.
With regards to telehealth technology, there are a few “givens” that we assume: that the technology is reasonably usable, that it is secure and also reliable (assuming good internet connectivity).
The metrics to capture under “technical performance” should simply be on whether the clinician and patient could easily connect and that there are no audio/visual problems.
Any deviation from those goals is mostly the cause of individual circumstances on the clinician’s or patient’s side. Most user experience problems (on either side) can easily be compensated by workflow or process interventions, such as Pre-Visit TechChecks, and by training and coaching, e.g., on “webside manners”.
Of the 5 critical metrics, the first 3 can be measured intermittently, whereas the financial metrics should be measured continuously.
The “overall visit volume by modality” metric is critical in providing a good overall picture of the performance of your healthcare organization. It should include attributes such as date, time, provider, visit type, show/no show, and modality (one of: inpatient, outpatient, video visit, telephonic visit).
Semi-automated analysis of this metric can reveal a multitude of insights: comparison to prior year volumes, distribution (and shift across all modalities), adoption by individual providers or provider groups), change in no-show rates, etc.
The “overall reimbursement by modality” metric provides critical insight into the financial performance of the organization. It should include similar attributes, including date, time, provider, modality, CPT code, payor/health plan, and actual reimbursement.
Here, semi-automated analysis of this metric can reveal an additional set of insights: e.g., comparison to prior year revenue, “the cost of telephonic vs. video telehealth”, average reimbursement per visit, usage by CPT code and modality, etc.
Using the Metrics to Drive Improvement
As I’ve stated in a prior article, “Action is the Ultimate Value of Measuring Performance”.
To implement “paying attention to”, all 5 metrics should be reported on a regular basis (weekly first, monthly later) in the form of a telehealth performance dashboard. Each metric must have a target goal along with a predefined action list in case the metric falls short of the goal, meets the goal, or exceeds the goal.
Driving in the dark without any feedback about direction, speed or the fill-level of the gas tank can be a very dangerous undertaking, especially if you are going 80 miles an hour. It is thus crucial for healthcare leaders to invest in establishing a telehealth performance dashboard that at a minimum includes these 5 critical telehealth metrics:
- Clinician Satisfaction
- Patient Satisfaction
- Technical Performance
- Overall Visit Volume by Modality
- Overall Reimbursement by Modality
Which telehealth metrics are your healthcare leaders evaluating on a regular basis? What predefined actions have you identified to overcome the challenges you are encountering?