If you don’t know where you’re going,
you’ll probably end up somewhere else.
— Yogi Berra
During the Covid-19 health crisis many organizations hastily launched telehealth. For many it was a stop-gap measure — an interim, makeshift alternative to the “traditional care”. Yet, telehealth in the form of video visits has been around for many decades. The longest-running telehealth programs have been around since the mid 1990s.
By now, most healthcare leaders have recognized that Telehealth is here to stay — while newcomers to the healthcare ecosystem like Amazon Care and Walmart Health are fully embracing a “virtual first” model.
What’s fascinating to consider is that the full embrace of telehealth as a viable part of a hybrid care delivery model is the inevitable direction of the future. The modern healthcare consumer has in the past decade already voted with their wallet — and now they’re voting with their mouse clicks, too.
As with any ship, without proper steering, the boat will drift aimlessly, guided only by the random wind and currents. So if telehealth is critical to economic sustainability, who is steering your telehealth success in your organization?
What is Telehealth Governance?
Most healthcare organizations only recognize governance from the perspective of an external board that governs the organization and is the CEO’s boss.
The Baldrige Performance Excellence Program defines governance as the “system of management and controls exercised in the stewardship of your organization.” Thus governance focuses at its core on the wellbeing and survival of the organization.
Telehealth, as a healthcare delivery service alternative to in-person care, requires, just like in-person care, the involvement of the whole organization: from clinicians to compliance, from schedulers to billing, from nurses to marketers. In order to implement a well-performing parallel care delivery system, it likewise requires the involvement of the leaders of the various functions.
Which should be represented on a telehealth governance team such as a steering team.
Telehealth Governance Responsibilities
The basic responsibilities of a telehealth governance team are no different than those of great leadership: establish objectives, supply resources & support and hold the organization accountable.
Specifically, here are the three most important telehealth governance responsibilities:
- Direct the expansion, growth, and continuous improvement of telehealth.
- Allocate resources and remove obstacles to accomplish the goals set forth.
- Provide accountability on the performance of existing and new telehealth services.
The first challenge that a telehealth governance team needs to grapple with is the identification and prioritization of the key objectives for the next months. Without the clarity of what to focus on, the organization’s progress will be limited. Do you want to optimize telehealth performance? Do you want to launch a new telehealth service, e.g., with schools?
Once the objectives are clear, the steering team needs to provide the resources. That includes people to project-manage and accomplish the objectives; in-house expertise that can aid in workflow design, continuous improvement, technology selection, etc.; or funds to invest in technology or in outside expertise.
Finally, with so much competing attention for staff’s time (especially if the resources are not provided in adequate supply – e.g., by asking people to do the job of two people in order to avoid spending money on bringing outside expertise in), the steering team needs to provide accountability. If progress is not happening at the right pace the solution lies in allocating better, or the right, or more resources — or in helping to reprioritize competing priorities.
Telehealth Governance Composition
So who should sit on an effective governance board? Ideally, a cross-representation from the various functional areas such as executive leaders, clinicians, operations, finance, technology, etc. Depending on the size of the organization and the leadership culture, the individuals can be senior leaders, departmental leaders, or delegates.
In smaller organizations, Telehealth Governance may simply be a monthly recurring topic on the executive leadership’s agenda. In larger organizations, middle managers and subject matter experts will make up the composition of the team.
And the leadership? Since telehealth is not a technology, not a set of workflows, but rather a clinical tool, the leadership of Telehealth Governance should come from a clinical-administrative partnership. In larger organizations, a clinician is designated as medical director of telehealth or virtual care. In smaller organizations it may be a clinician with strong affinity for telehealth or the administrator of clinical operations.
Overall, the investment in telehealth governance is cheap compared to the alternative of grossly underperforming telehealth that will ultimately threaten the economic survival of the organization. Because if you don’t know where you want your telehealth program to go, your patients may just wind up somewhere else.
Have you established telehealth governance? Who is leading your team? Please post your thoughts and reactions and in the comments below.
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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.
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