Oct 21 2021

4 Lessons from Scaling Telehealth During a Crisis

As organizations evaluate virtual care programs, IT leaders must assess infrastructure, security and impact on care delivery — and determine how partners can help.

Monument Health’s rapid expansion of telehealth in the early days of COVID-19 is a familiar story: Evaluate vendors and sign a contract in a matter of hours and roll out technology to support virtual visits in a matter of days. At the height of the pandemic, the South Dakota-based health system conducted as many as 800 virtual visits per day, accounting for most outpatient visits.

As hospital systems such as Monument Health evaluate their telehealth and digital health strategies in light of their COVID-19 response, it’s important to remember that telehealth can serve as an extension of in-person care and not just a stopgap measure, notes Lisa Hines, strategic adviser for global healthcare at NetApp.

“It’s really no different than a capital expansion project,” says Hines, who spent more than two decades in IT leadership roles in health systems, including serving as a director of telehealth for Greenville Health System (now Prisma Health). “No one goes into the planning process for a new emergency department without putting in the energy and effort to facilitate process and quality improvement and to better meet the needs of patients and providers. You need to approach telehealth with the same energy and stickiness.”

Hines offers four lessons for hospitals and health systems as they continue to scale their use of telehealth in the wake of pandemic.

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1. Reassess Existing Infrastructure to Support Digital Strategy

Pointing to the mantra of “people, process, technology,” Hines refers to technology as a major “building block” of telehealth and recommends that organizations focus heavily on people and process to ensure the technology is used effectively.

The shift in process and mindset is similar to the transition from paper records to electronic health records (EHRs), she says: “We clearly learned that’s not an initiative limited to IT.”

Successful telehealth implementation requires revamping processes for documentation, billing and reimbursement. In doing so, organizations shouldn’t be surprised if they uncover workarounds that clinical and administrative staff had put in place when paper-based workflows were the norm, Hines says. “Once you create a service that depends on automation technology, that’s when you realize the need for standardized processes.”

2. Make Security an Essential Part of Virtual Care

Leveraging a virtual desktop infrastructure (VDI) as part of a telehealth strategy gives clinical professionals the same level of security — and the same user experience — that they are used to with traditional, on-premises technology deployments, Hines says.

This practice of bringing security to the edge can complement digital strategy in two key ways. One is enabling clinical staff to provide care remotely, whether it’s at a community clinic or, in the case of COVID-19 response, from the safety of home. This is particularly helpful for specialties such as oncology, where continuity of care is critical even amid a pandemic, Hines says.

LEARN MORE: Find out why telehealth security is important for healthcare.

The other benefit is the ability to scale services up and down as needed. This could involve setting up a field hospital as part of disaster response or onboarding additional staff due to a patient surge, staff shortage or other short-term need for help. “When VDI is in place, there are no obstacles to ramping up,” Hines says.

3. Make Telehealth Foundational to Care Delivery

Healthcare’s pandemic response demonstrated the long-term viability of telehealth. That means organizations need to look at how to incorporate telehealth into their larger strategy for improving care delivery, Hines says.

“Hours and hours of planning go into construction projects. You look at benefits such as improved throughput, increased capacity and better access to care. Why would we not create a digital health strategy with the same diligence?” Hines says. Telehealth technology should be just as important to the organization as the EHR or the imaging system, she adds: “It is a critical clinical application. It can’t go down.”

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The ideal starting point for this process is focusing on an organization’s unmet care needs, such as limited access to specialty care or long wait times for urgent care. It’s also important to identify key performance indicators to measure program progress and sustainability, Hines says. Revenue and reimbursement, clinical quality and provider performance are among the most important metrics.

4. Build Strategic Partnerships as Necessary

Returning to the idea of people, process and technology, Hines refers to the need for an ecosystem that can support all three components, strengthened by partner relationships where needed.

  • Technology partners should have an innovative solution and a proven track record, which should include an emphasis on security and integrating telehealth into EHRs and other clinical applications.
  • Process partners, which could be vendors or consultants, can evaluate and document clinical workflows and other business processes to lay the foundation for staff training.
  • People, including IT and clinical staff, must be aware of what a program looks like. “They need to know that devices are on 24/7. They need to know it’s not just setting up a camera,” Hines says. “They must be trained and ready to go.”

Whether healthcare organizations should work with one partner or several depends on what their overall ecosystems look like, Hines says. “You need to assess where you need help and whether you have the skill set or bandwidth internally to give it the right attention.”

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