For a number of years now, I have been harping on the theme: that the problem in healthcare is not the lack of innovation, but the slow pace of innovation adoption. That there’s a $100B avalanche of viable and valuable Digital Health innovation coming towards us — and if we don’t “use it”, others, outside of our traditional healthcare delivery system, will find a way to use it.
A shallow, biased history of recent healthcare ventures
As it turns out, this is not as straightforward as I feared. Exhibit A: the shutdown of Amazon Care and of Haven in 2021 and 2022. Exhibit B: the closing of Walmart Health and Optum’s Telehealth arm in 2024.
These for-profit entities experimenting with new healthcare business models can close unprofitable ventures at any moment. Which is a luxury most hospitals, health centers, and health systems simply cannot afford (morally and financially) — as it would be leaving thousands of patients with worse access to care and hundreds of people scrambling for a job.
But make no mistake: like the terminator, they WILL be back (baby). As any good general they cut their losses on the battle field, retreat, regroup, rebuild, and will re-engage differently and better.
Meanwhile, while these innovation-adoption powerhouses are trying to figure out which patient population to target to i̶n̶c̶r̶e̶a̶s̶e̶ ̶p̶r̶o̶f̶i̶t̶a̶b̶i̶l̶i̶t̶y̶ create a sustainable business model, our “regular” healthcare delivery system has to soldier on, basically being left “holding the bag”. Especially the many safety net organizations that we work with (FQHCs, RHCs, and CAHs) are taking whatever patient walks in the door — no cherry picking allowed.
My biggest concern is that the razor thin margins of our traditional care delivery system is oftentimes only held up by also caring for those patient populations who are well insured and not that sick. Which is exactly the type of patient these for-profit, tech-enabled healthcare ventures will be going after.
But by siphoning off the cream of the crop (and plucking those cherries, too, for good measure) they’d be destroying the barely survivable business model of the US’s safety network.
And why not? Of course those privately insured, tech-savvy patients in their prime would very much prefer to take advantage of the technological bells and whistles that make their care experience more efficient and more effective. Serving those with low digital literacy, multiple medical comorbidities, and underlying or resultant mental health issues is not a target market in the business models of these for profit ventures.|
So, what’s a healthcare leader to do?
The oscillation between “sticking your head in the sand” long enough to come up with “a deer in a headlight fright” that I saw healthcare leaders exhibit towards telehealth during the Covid years is obviously not a very productive strategy. Yes, the Covid-19 health crisis eventually blew over, but telehealth is still around and definitely here to stay.
Just in 2023 and 2024 we’ve seen similar (uninformed) knee-jerk responses to the perceived threat of AI in Healthcare.
These types of reactions (or even ignorance) have to stop and the energy expended should rather be put to good use to CREATE something new, rather than DEFENDING and PROTECTING the status quo.
So here’s my “if life gives you lemon, make lemonade” advice for healthcare leaders:
Use Telehealth as a Dress Rehearsal to create a culture of rapid digital health innovation adoption.
Yes, we have a crisis with clinician recruitment. Yes, many clinicians are burned out. Yes, payments for care are at unsustainable levels and further cost cutting seems impossible.
But technical innovation is not going to stop.
With the demonstration of the capabilities of AI through Chat GPT in 2023 we’ve now crossed a threshold that will accelerate the availability of valuable innovative solutions even more. A non-linear, exponential growth, with doubling of performance or accuracy occurring now in months rather than years.
Retooling Healthcare Leadership through Telehealth
So on top of all the big challenges, healthcare leaders now also have to find a way to accelerate the adoption of digital health innovation: to evaluate new solutions in days, adopt them to their culture and systems in weeks, and validate them quickly before deploying them in months.
But rather than going out into the innovation marketplace to bite your teeth on some innovative, AI-enabled digital health solutions, why not stretch and grow your “innovation adoption muscles” by something you already have in place? Telehealth!
Covid demonstrated the feasibility and value of video visits and many healthcare organizations have also doubled down on remote physiological monitoring (RPM) to get a better handle on patients with multiple chronic diseases.
But there are plenty of more uses for telehealth (e.g., these 9 modalities or these 96 scenarios). Most organizations are also still operating at the “chaotic” and “emerging” levels of telehealth maturity.
So the premise I pose is that: by learning how to get really good at telehealth, you are teaching your organization how to leverage technical innovation to improve care delivery. The elements and leadership skills needed to succeed are actually the same!
Elements of Stellar Telehealth Performance
The key elements for superb telehealth performance are as follows:
(1) A Telehealth Strategy that shares an inspiring vision, sets strategic priorities, and lays out a strategic roadmap for which initiatives to complete and which telehealth services to launch in what order.
(2) An engaged and empowered Telehealth Governance and Leadership team that provides resources, removes obstacles, and provides accountability.
(3) Appropriate and pragmatic Telehealth Policies that ensure compliance with laws and regulations and create proper behavior. This also includes clinician-generated Clinical Guidelines for Telehealth, defining appropriateness and conduct.
(4) A solid set of documented and continuously improving Telehealth Workflows that define the integration of telehealth technologies.
(5) A stack of user-friendly Telehealth Technologies that are safe and secure; that create satisfaction among clinicians, staff, and patients; and that are integrated with other health IT solutions, as needed.
(6) Dedicated, empowered, and trained/coached operational and technical Telehealth Support that ensures a great experience by clinicians and patients.
(7) Comprehensive, yet pragmatic Telehealth Training on the strategy, the policies, the workflows, the technologies and the availability of support.
As you can easily see, all of these elements have to be in place for any type of new technology. Each new technology needs to align with a strategy that explains the “Why”. Each needs policies and clinical guidelines, workflows, support, and training.
So once your organization becomes proficient at launching new telehealth modalities, you are prepared to adopt any innovative digital health solution.



Leadership Skills for Telehealth Success
To put all of these elements in place, the executive leaders and senior leaders must become proficient in these five leadership skills:
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Innovation Leadership – identifying and quickly deciding which new telehealth opportunities should be implemented.
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Change Leadership – taking the clinicians and staff from the status quo to the “new world” that uses telehealth regularly and appropriately
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Project Leadership – to succeed in constant innovation adoption, leaders must set the expectation and provide resources to ensure sound project management.
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Process Leadership – insisting on the proper documentation of all workflows and all potential scenarios, including exceptions.
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Improvement Leadership – effective leaders not only launch new innovation, they make sure that the innovation actually works and therefore continually monitor its performance and drive improvement.
For more information see the “5 Leader-Ships of Innovation Adoption”.
Curtain Up! It’s time for the Premiere!
The avalanche of digital health innovation and the tsunami of AI-enabled solutions for healthcare is unstoppably barreling towards the healthcare industry.
The questions leaders need to ask themselves is whether they are willing to risk the potential fate of being crushed and drowned by them, or whether to invest in retooling their own skillset, the skillset of their senior leaders, and to empower and enable clinicians to practice medicine well by taking advantage of these innovative solutions.
Using Telehealth as a Dress Rehearsal is the most effective and efficient way to prepare for the future.
What could a 6-month dress rehearsal look like for your organization? Connect with Ingenium’s CEO Christian Milaster to discuss.















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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.