Transforming Care Delivery through Telehealth

Most healthcare organizations jumped into telehealth in earnest during the Covid-19 health crisis — not to revolutionize care delivery, but rather to continue to serve the patient population during the highly contagious and deadly pandemic.

But even before Covid, most organizations’ telehealth efforts started small and uncoordinated — passionate efforts of individual clinicians to leverage technology to better serve their patients.

Recognizing how many teams started and got stuck at different levels of telehealth maturity, a telehealth maturity model emerged, describing how organizations (should) progress from the early stages of “chaotic”, “emerging”, and “uncoordinated” to the more structured maturity levels of “supported” and “integrated”.

(See ”How Mature is Your Telehealth Program?” for an introduction to the Telehealth Maturity Model and review “From Chaos to Supported: Growing Telehealth Maturity” for a more in-depth description of levels 0 through 3 of the Telehealth Maturity Model).

The Higher Stages of Maturity

As with the human experience (or even the metamorphosis of the caterpillar into the butterfly), telehealth programs undergo their own life cycle as the maturity of the telehealth services and the telehealth program grows. The three stages that follow the “Supported” level are: Integrated, Strategic, and Transformative.

Here are their definitions:

Level 4 — Integrated: Once a centralized support team with best practices can manage the proper launch of new services, telehealth can quickly spread across all specialties and all modalities — whether to offer patients access to specialty care or integrating remote patient monitoring services. From a patient’s perspective, receiving care online across a spectrum of services is seamless. In addition, clinical data generated during telehealth visits or remotely collected is available in the patient’s medical record for clinical decision making.

Level 5 — Strategic: At the strategic level, organizations are fully leveraging telehealth by proactively using the launch of new telehealth services and the expansion of existing services to drive the fulfillment of their overall organizational strategic objectives. Engaging with patients at a distance and in person is the organization’s “new normal”, moving closer to a “Virtual First” model.

Level 6 — Transformative: At the highest maturity level, healthcare organizations are completely redefining care delivery by creating innovative care delivery models including virtual hospitals. Where necessary, transformative organizations design and develop their own telehealth solutions to meet their innovative needs. The organization is in continuous pursuit of constantly reviewing and improving its telehealth capabilities and moving towards enabling “Empowered Wellness” for its patients by truly delivering connected care.

From Supported to Integrated

While “skipping levels” or accelerated progression through each level is possible in the lower levels of maturity, to reach Level 4, “Integrated”, the organization must invest in reaching Level 3, “Supported” first. This entails at a minimum the assignment of dedicated resources to manage the ongoing support of telehealth services across all sites and all specialties — including an operational and a medical telehealth director, a telehealth coordinator, and a technical telehealth support person.

From this base level of maturity, the organization can now — with the use of repeatable and scalable approaches that support the optimization, growth, expansion, and launch of telehealth services — start to roll out and grow and expand telehealth services in all areas of the organization that have an interest. At this maturity level it is still very much a “pull effort”, i.e., growth will depend on various clinical stakeholders to develop a personal interest in leveraging telehealth in their practice and seeking operational and technical support.

Once telehealth has been established across multiple service lines as a viable alternative to the traditional in-person and outpatient care delivery models, it can be thought of as having reached “Level 4 — Integrated”.

From Integrated to Strategic

One of the biggest shifts in how Telehealth is perceived and treated occurs when the momentum of telehealth fully reaches the consciousness of the senior leadership team. Whereas Telehealth may have previously shown up as a singular strategic objective, once an organization reaches “Level 5 — Strategic”, telehealth is no longer seen as a separate “project” but a strategic tool that virtually(!) can advance most of not all of the organization’s strategic objectives.

To illustrate this point, just look at this quick brainstorm on how telehealth can create strategic success: achieving the organizational strategic objectives across the typical six pillars of a healthcare organization’s strategic plan:

At this maturity level, telehealth is no longer merely a way to deliver care, but is proactively used as a strategic tool. See “Telehealth Creates Strategic Success” for more information.

Leveraging Telehealth to Transform Care Delivery

The pinnacle of telehealth maturity, the summit, is “Level 6 – Transformative”.

While it is in many respects similar to “Level 5 – Strategic”, this level is more about the timing of when senior leadership ponders the question: “How can we leverage telehealth to reimagine, to reinvent the way we deliver care?”

Innovative, forward thinking of all sizes will no longer merely ask the question “how can telehealth help us to achieve our objectives” but rather ask the more revolutionary question of: “How can we leverage telehealth solutions to deliver extraordinary care?”. How can we take full advantage of technology and innovation to not only enable our clinicians to practice on top of their license, but to put the needs and care preferences of our patients first?

That’s when organizations truly complete their journey to full maturity: by fully embracing and embedding “care at a distance” solutions to focus on excellent outcomes at a lower cost with higher satisfaction for clinicians and patients alike.

That’s telehealth at its finest.

Are we There Yet?

So is this state, this level an illusionary pipedream? I don’t think so.

For years, I’ve seen promising beginnings of a transition to “Transformative” in numerous well-run telehealth programs. E.g., the way that Lehigh Valley and Jefferson Health (both in Pennsylvania) or Intermountain Health in Utah have reimagined their organizations’ care delivery services is an example of how to tap into the Transformative potential of telehealth.

To move through the various maturity levels, it does not matter if you are a small specialty practice, an urgent care center, a behavioral health clinic or a fully integrated service delivery network. The model works well for all sizes of organizations, just that smaller organizations can get there in a matter of months, not years.

So, where do you think your organization’s maturity level is at? Check out this Telehealth Maturity Model Self Assessment or set up a call to discuss your telehealth program.