Over the past week’s I’ve been writing a lot about the what, the how, and the why of measuring the performance of your telehealth services. Today’s column presents another argument as to why measuring telehealth performance is important: because telehealth is a tool that creates strategic success.
When wielded correctly in the hands of a capable leadership team, telehealth will move your success metrics across virtually all of your strategic objectives.
Most healthcare organizations were thrust into the use of Telehealth in response to the Covid-19 crisis and many of them seem to be using a set and forget approach: “we started doing it, it was high during Covid, now it’s low, I guess that’s okay”. What those leaders are missing out on is the phenomenal “side effects” that well executed services will have on the overall performance of their organization.
The Times They are A-Changin’
In January 2020, John Halamka, a physician and renowned digital health thought leader joined the Mayo Clinic in Rochester, Minnesota to lead Mayo’s digital transformation. Within six months into the job, Mayo’s original 10-year plan to fully take advantage of digital transformation had been accelerated to not even one year.
As he said at the time in a Becker’s Hospital Review article, “We’re going to have more demand for telemedicine, telehealth, hospital-level care in the home, wearables and the ability to apply machine learning and artificial intelligence to new data sources for cure plans.”
Covid-19 has not only changed the way we work, teach, and socialize. In our assessment, the pandemic has spurred healthcare’s most rapid, fastest change ever in the history of medicine. Neither antiseptic surgery — discovered and refined by Lister and inspired by the findings of Pasteur — nor the use of anticoagulants in cardiologyL all of these innovations had many opponents (just like telehealth does now) yet it took decades for those changes to find even a 50% adoption rate.
The Modern Healthcare Consumer
What is different from those past innovations in healthcare is that this time the patient — or rather, the Modern Healthcare Consumer — has a seat at the decision table. For the past 15 years, empowered by Google and prepared by the Smartphone, the modern patient is taking matters into their own hands when it comes to making decisions about their health.
The Modern Healthcare Consumer, being comfortable with technology and striving for convenience just like in all other areas of their lives, is demanding more comfort, more transparency, faster access to the innovations not from 15 years ago but those released within the last 15 months.
Thus to sustain any healthcare delivery organizations business model — whether that’s a physician practice, a rural health system, a mental health agency, or an academic medical center — every organization must pay attention to the growing “convenience competition” that is targeting the Modern Healthcare Consumers’ eyeballs and wallet.
But this is not an article about staving off the innovative disruptors. What I am focusing on is something much more substantial, more broad: the ability for Telehealth (“delivering care at a distance”) and other Digital Health Solutions to significantly help any healthcare organization to achieve all of its strategic objectives, to enable the sustainability of its business.
A Blueprint for Healthcare Strategy
Many healthcare organizations, in one way or another, are using these days a variation on the Studer Group’s categories for healthcare strategy: Provide an increasingly great service, improve quality, find and keep great people, improve the finances, achieve volume and financial growth and be a good citizen in your communities.
What’s interesting to realize is how much telehealth and telemedicine services can help organizations move the needle into the right direction across all of those six areas.
Better service, better patient retention
As illustrated by Dr. Halamka’s quote, the demand for telehealth and digital health services is only going to increase, it will not go back to pre-Covid-19 volumes.
And why should it? At least three-quarters of outpatient visits, if not more, do not require a hands on examination, at least not by the physician. A 12-minute visit with a physician typically takes patients at least 6 times as much time to make it to the appointment, check in, wait and then the whole thing in reverse. A visit “from the comfort of your home” cuts out as much as 80% of that predominantly unproductive time.
A few years back my annual visit with my primary care provider, via telemedicine, took me 37 minutes (including 12 minutes of wait time that I used productively on email). I talked to his nurse and the scheduler on the phone and to the physician via video, successfully covering the five topics I had wanted to address.
In another example a colleague of mine had a 3-month frozen shoulder injury follow up appointment via telemedicine that took a mere 3 minutes and maybe, if even, 10 minutes of her time.
With experiences like these, why would anyone want to go back to in-person care for every visit? Our lives are so busy that we often put off medical care until it becomes urgent. While going to the doctor in some cases is never “fun”, the additional dread of the logistics surrounding a traditional visit causes many people to delay care. And quite a few people don’t even have the luxury of taking time off of work, arranging for childcare or being able to afford transportation.
Through Telehealth many smaller healthcare organizations can also facilitate convenient access to specialty services, providing patients with a “one-stop shopping’ experience. In addition, telehealth opens the door for additional, virtual service lines, e.g., genetic counseling or specialized physical therapy.
More Engagement, better Outcomes
When care is quickly accessible, when it is convenient, numerous studies have shown a significant reduction in high cost utilization (such as ED or hospital admissions), and with that, the quality of care improves measurably.
Many health outcomes are influenced by the degree to which a patient is engaged in their care. Easy, direct access to the physician and staff via a highly relatable communication mechanism such as video chat has also shown to increase patients’ participation in their care plan.
Telehealth not only offers opportunities for timelier access to care (before exacerbation), but also allows for better care transitions and with geographic distance no longer being a barrier, providing opportunities for improving the continuity of care.
Finances and Growth
On the revenue and profit side, with reimbursements for telehealth being for the most part on par with in-person care, a number of telehealth services can lead to an increase in revenue. This could be through new service lines provided by a remotely-located specialist or through arrangements with other regional networks.
When quality metrics are tied to rewards and penalties (such as for 30-day readmission), small, targeted investments into telemedicine can achieve significant savings.
Furthermore, when the majority of outpatient visits can be conducted at a distance, the definition of a geographic area that a healthcare organization can serve can be significantly expanded. And with growing competition (even from the patients insurers offering telemedicine services to their members) investing in telehealth is a good strategy to avoid revenue erosion.
Finally, with the cost of new patient acquisition typically being high, especially in markets where patients have choices, offering a convenient, modern way to receive the care when they need it where they want it can go a long way towards patient loyalty and retention.
People and Community
But telehealth does not only have a positive impact on patients or on the bottom line. The people side of an organizations’ strategy can benefit just as well from telehealth. Many providers and staff have realized for a few years now that experience and good skills in all things digital health are critical for their future career.
As many have discovered across all industries, distance work also allows for a much greater flexibility, further increasing job satisfaction when trying to align work and family schedules. Investing in Telehealth thus can help to attract and retain talent.
The launch of a new telehealth service (e.g., via a remote clinic or offering access to a new subspecialty) also presents a unique opportunity to define how healthcare could be delivered most optimally, so that everyone can practice “on top of their license”. That redefinition alone can significantly increase physician and staff satisfaction which in turn leads to better patient outcomes.
Last but certainly not least, telehealth services empower any healthcare provider to truly be a supporter of the surrounding communities, especially those with severely limited access to care or transportation (often both). The internet offers opportunities for health education and innovations. And advances in monitoring technology now allow for an easy-to-deploy solution to support people with chronic diseases, even in the absence of a local clinic or home nursing services.
To Sustainability and Beyond
Telehealth is not merely a video chat software to give to physicians and say “here, use this to talk to your patients, it’s safer”. Telehealth has long been regarded by many experts (watch the video) primarily as a clinical tool — a means to deliver care to patients where they want and where they need it.
Telehealth, when applied correctly, is a strong tool in the tool chest of healthcare organizations’ leadership. It’s a tool that leadership can use to move the needles of organizational strategy into the right direction across all strategic objectives.
Don’t believe me? Send me your top 12 strategic objectives, and I’ll send you at least 2 ways for each objective, how you can use telehealth and digital health to contribute to being successful with each of your 12 strategic objectives.
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Christian Milaster and his team optimize Telehealth Services for health systems and physician practices. Christian is the Founder and President of Ingenium Digital Health Advisors where he and his expert consortium partner with healthcare leaders to enable the delivery of extraordinary care.
Contact Christian by phone or text at 657-464-3648, via email, or video chat.
