Extraordinary Telehealth’s Hierarchy of Needs

Many of us, mostly in college, have come across the framework of Maslow’s hierarchy of needs.

To reach the highest level, the level of self-actualization, people first need to have some of their basic (physiological) needs met, such as breathing, food, water, sleep, etc. A second set of basic needs, focused on safety, include health, shelter, a safe environment, etc.

The next two levels address humans’ psychological needs, such as intimate relationships and friendships, followed by esteem needs such as respect, status, recognition, being proud of oneself, a sense of accomplishment, making a contribution, etc.

Having one’s needs met at these levels opens the door to the highest level, that of self-actualization: to be creative, to reach one’s full potential.

The premise of Maslow’s model is that you cannot reach and sustainably stay in the higher levels until you have your needs met in the lower levels.

As we’ll explore in the following sections, that principle — and the order in which those various needs are met — also holds true for achieving extraordinary telehealth.

Basic Needs

At the physical level, akin to the physiological needs of Maslow’s hierarchy, extraordinary telehealth requires the following on both, the clinicians’ side and the patients’ side:

• adequate technology in the form of good hardware such as a monitor, webcam, microphone, speakers, proper lighting, and an adequately equipped computing device.
• reliable connectivity on both ends in terms of bandwidth (driving the quality of the sound and video) and latency (resulting in no dropped or stuttering connections)
• software solutions (“apps”) providing a good experience before, during, and after the telehealth visit

On the safety level the requirements include:

• security — such as encryption to protect the connection and the protection of the patient’s health information
• privacy — not only to protect the digital health information, but also to protect both participants of a video visit from being overheard (or electronically transmitted information falling into the wrong hands)
• cost — the fees for providing telehealth (for the clinic and the clinicians), as well as the price to use telehealth (for the patients), must be affordable (or reimbursed)

Psychological Needs

Once the basic needs have been met, a telehealth service must next meet the clinicians’ and patients’ psychological needs in order to be experienced as “extraordinary”.

On the clinical side, that includes the feeling that everyone who is contributing to the success of telehealth is playing together as a team. The schedulers, the medical assistants, the nurses, the clinicians, the billing staff, the technical support staff, the marketing team, the legal team, and leadership all must work together like a well-oiled machine, each doing their part to contribute to an “extraordinary experience”.

On the patient side, the same logic applies: each person of the care team that the patient interacts with is part of the patient’s telehealth experience. Telehealth (or any care for that matter) is perceived much better when the patients feel taken care of, which includes courtesy and frequent communication to keep them “in the loop”.

On the esteem level this also includes, on the clinical side, celebrating the successes, e.g., for clinicians to share how a telehealth visit made a difference in a patient’s care journey. Years ago a psychiatrist shared with her team how the ability to see a patient in crisis via telehealth on a Friday afternoon prevented a hospitalization, since the patient, who lived 40 miles away, would not have been able to get transportation to see the psychiatrist in person. That story made everyone on the team feel good for weeks. And I remember it still, over 10 years later.

Esteem also pertains to making it easy for patients (and clinicians) to be delighted — from a process perspective as well as from a technology perspective. Many software solutions used for telehealth are unnecessarily cumbersome and not optimized for the patient experience and/or the clinician experience. In addition to user-friendly software, the training of both clinicians and patients on the easiest use of the technology and the accompanying process steps is also key to creating a feeling of mastery and accomplishment. Nothing frustrates a patient or a clinician more than feeling stupid when they can’t get the technology to work right. The goal is to make the experience as smooth as possible, so patients and clinicians feel in control.

Extraordinary Telehealth

Once all these fundamental needs are met — reliable, working technology; no concerns about privacy; and an easy experience that leaves you feeling good — then clinicians and patients can both engage in making the televisit an extraordinary care experience.

Imagine no frustration or distraction with getting onto the virtual call. The technology fades away instantaneously as doctor and patient are discussing the patient’s health and care plan. The result is a significant drop in no-shows, cancellations or video visits that had to convert to a phone call. Patients feel connected and clinicians are focusing on providing excellent care, performing at their best.

As Maslow laid out in his framework: the ultimate goal is to achieve one’s full potential. For clinicians that means that they are fully practicing “on top of their license”, which I here mean to say that they are solely focused on practicing medicine — not on technical troubleshooting or cumbersomely hunting for information they need.

When the processes and the technology fade away, the patient and the doctor can act as a team, being creative, being spontaneous. With great telehealth solutions and processes in place, clinicians can share valuable resources with patients in real-time, play video clips to make their point, share test results and annotate them, or draw on a virtual whiteboard to illustrate their teaching.

That – and more — is the ultimate self-actualization of integrating telehealth in the delivery of care. That is the delivery of extraordinary care at a distance.

And that is our team’s vision for telehealth.

Do you want to reach your Telehealth Nirvana? Then reach out to me to explore the tools we offer to optimize your clinician’s and your patients’ telehealth experience.