Extraordinary Telehealth’s Hierarchy of Needs

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

To reach the highest level, that 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 basic level, akin to the physiological needs of Maslow’s hierarchy, extraordinary telehealth requires the basics on both, the clinician’s side and the patient’s 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 needs” side the requirements include

• security — such as encryption to protect the connection
• privacy — not only to protect the digital health information, but also to protect both participants from being overheard
• cost — the price to run telehealth (for the clinic) as well as the price to use telehealth (for the patients) must be affordable

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

On the patient side, the same logic applies: each person of the care team that the patient interacts with is part of their telehealth experience. Telehealth (or any care for that matter) is perceived much better, when the patients feel taken care of.

On the esteem level, this also includes, on the clinic 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, 10 years later.