From Chaos to Supported: Growing Telehealth Maturity

In last week’s article, I posed the question: How Mature is Your Telehealth Program? In today’s Telehealth Tuesday column I’ll dive deeper into the first four levels of telehealth maturity: from chaotic to emerging to coordinated to supported.

A Journey with the End in Mind

When we start working with clients, the first “maturity destination” we chart for them is the maturity level of “Level 3 — Supported”. At this level, the organization has fully embraced telehealth and has designated resources, primarily staff, to centrally provide support for telehealth.

This level is so important (and a good resting place before advancing to the next three levels) because it forms the foundation for a more advanced utilization of telehealth beyond the mere augmentation of outpatient and inpatient services with the occasional video visit. The level of “Supported” is the base from which an organization can expand into reaching “Level 4 — Integrated”, which is a significant mind shift from the historical use of telehealth as a stop gap measure.

At Level 3 — Supported, the senior leadership of the organization fully embraces and values telehealth as a viable clinical care delivery tool and provides the necessary resources to provide sufficient operational and technical support. In addition, at this level, a designated, skilled team is charged with assisting the various clinics and medical specialties with the launch of new telehealth services through change management, project management, clinical workflow design, technology selection and training.

It all starts with Chaos

So where do most organizations start in telehealth? Most organizations, especially during the early months of the Covid-19 health crisis, started out at “Level 0 — Chaotic”. Each department, each service line (and even in some cases each physician) was permitted to launch telehealth in the way they thought was right or at least acceptable. Before Covid, enthusiastic staff, often clinicians, would secure access to telehealth technology, often with little to no coordination with IT or involvement of Finance and no coordination with other departments.

But the “Chaotic” level is not all bad. With a dedicated clinical champion, the “just do it” attitude at this level can quickly create successes in mere days that would otherwise take months to achieve. And that rapid success can serve as a positive inspiration to the rest of the organization to pave the way for a broader adoption.

But the danger of launching telehealth with little to no strategic thought and no centralized, experienced support is that many services will fall short of their potential, because a single person, especially a clinician, can only do so much.

Soon after the 2020 health crisis pointed a bright spotlight on telehealth, there was much more awareness by senior leadership, yet oftentimes no true support. The result was (and is) dismally performing telehealth service with many disillusioned clinicians that leave patient’s puzzled as to why their experience was so bad compared to their or their friends’ and family’s experience with other providers.

Telehealth Grows Up

At the next level, “Level 1 — Emerging”, leadership becomes aware of the strategic need for telehealth yet still does not set aside a central resource to aid in the launch and in the sustaining operation of existing and new telehealth services.

At this level of maturity, the adoption of telehealth services is accelerating and one of the first to notice (and the first to put some support behind it) is the IT team, because ultimately things eventually break. While it was okay to get a Telehealth account license online, working on the actual integration and configuration does require IT expertise.

At organizations with an “Emerging” maturity level, leadership awareness and endorsement (though not support) is present, IT is much more involved and some attention is paid to the financial performance of the services.

Surprisingly at the brink of 2024 many organizations still consider telehealth a minor afterthought, with still no designated experienced telehealth support assigned to ensure that patients and physicians have a good experience.

The last level before the first final destination is “Level 2 — Coordinated”. Here, the different telehealth services across the organization (e.g., direct to home, site-to-site, or school-based telehealth) are coordinating and sharing learnings from their efforts. At times an unofficial person, sometimes from billing, sometimes from IT, and sometimes from informatics, emerges as the knowledgeable resource, though the position is not appropriately funded. Success is still based on the heroic efforts of a few individuals.

Are we there yet?

Without leadership’s involvement and support, things don’t really move beyond the coordinated level, since launching telehealth successfully requires a multi-disciplinary approach. This includes leveraging technical support, billing knowledge, compliance, project management, video training, and clinical workflow design. Without it, progress is hindered until dedicated resources are allocated to supporting the launch and operations of telehealth.

In order to reach “Level 3 — Supported”, leadership truly needs to “wrap their mind around” that telehealth is there to stay and has established itself as a viable, long-term care delivery mechanism, akin to in-person outpatient visits and inpatient visits.

All of the health systems we work with want to reach the Supported level and are primarily interested in the development of a telehealth program strategy and a telehealth program business plan that looks more systematically at the opportunities ahead.

Look for next week’s article for an exploration on the Levels 4, 5, and 6 to literally take telehealth maturity (and its value to the clinicians and the patients) to the next level.

Where would you put your organization’s maturity level? Are you fully at level 3? When do you think you’ll reach level 4 (“Integrated”) or level 5 (“Strategic”)?

Check out our Telehealth Maturity self-assessment tool that assesses your organization’s telehealth support across 10 different categories.