New Report Lists 4 Imperatives of a Mature Virtual Care Strategy

Research by the Health Management Academy (The Academy) and Teladoc Health finds that many leading health systems place high value on a digital health strategy, but they haven't reached a point where that strategy is sustainable.

Many healthcare organizations have launched virtual care programs as a result of the pandemic, but how many have programs that are sustainable? A new report offers four recommendations for bridging that gap.

According to a survey of healthcare executives from 38 health systems across the country conducted by the Health Management Academy (The Academy) and Teladoc Health, there's a large gap between where health systems want to be with virtual care and where they are now. The executives rated overall performance of their programs at only 2.9 on a scale of 1 to 5, with the lowest marks focused on care model design, workforce readiness, clinician satisfaction, consistency of experience, and patient satisfaction.

"The problem is that technology alone won’t solve integrated virtual care," the report, prepared by Victoria Stelfox and Anne Herleth of The Academy, states. "Health systems need the wrap-around functions that support virtual care technologies. But because health systems haven’t migrated toward organized, system-wide virtual care programs, they haven’t yet mastered the critical workforce and organizational inputs required to succeed."

Health system executives see a mature virtual care program as being integrated, consumer-focused, and scalable, but are having problems reaching that point. Many jumped on the bandwagon over the past few years to deal with the COVID crisis, helped in part by federal and state waivers aimed at boosting access to and coverage of telehealth and digital health during the public health emergency. But they did so without a long-range strategy, or a plan to continue after the PHE ends.

To reach that level, the report lists four imperatives:

Develop a realistic and actionable digital health strategy. According to the report, many organizations say they have a strategy, but when pressed, they can't define or articulate it. In many cases they've used digital health to enable a strategy but haven't made that strategy a priority.

"Health systems leaders are quick to recognize that a clear digital strategy is needed to push forward on integrated care delivery (among many other strategic imperatives)," the report states. "But to do it, LHS [leading health systems] need to decide who they want to be as an organization—and for virtual care delivery, what markets they want to play in. These may not be quick or easy decisions, but it’s a critical step in moving from disjointed decisions to a scaled, system-wide investment plan."

Look beyond vendor contracts and focus on partnerships. A consumer-focused digital strategy is one of the top priorities for many health systems, and more than three-quarters of those surveyed are joining forces with outside organizations to reach their digital health goals. But many are contracting with vendors or other organizations in purely business terms.

"What is needed is skin in the game on both sides," the report notes. "For both health systems and industry organizations, a good partner is not based on metrics like pricing or contract terms. [Healthcare leaders] describe productive partnerships with terms like flexibility, ongoing communication, culture and values alignment, willingness to hear feedback, and long-term delivery on promises. Industry partners echoed similar sentiments, adding the value of long-term partnerships and aligned incentives."

Make sure everyone is on the same page and supportive. The biggest mistake that health systems make in launching a digital health program is forgetting to include (or ignoring) key participants, such as nurses, or failing to secure support from everyone involved.

"Our data shows that it’s uncommon for operational leaders to be involved in virtual health strategy, despite often being held responsible for the performance of the tools," the report notes. "The result is that projects end up floundering and leaders wonder why the implementation hasn’t been successful. CMIOs and population health leaders observe that they are often brought into implementation conversations during the later stages of virtual health investments, negating the chance for them to provide early and actionable feedback."

"Virtual health implementations today can avoid mistakes of the past by involving key stakeholders early and selectively choosing solutions that make clinicians’ lives easier—not more complicated," the report concludes.

Proceed cautiously with scaling. Many digital health programs start small, addressing a specific pain point or population to prove that they work, and then branch upwards and outwards. But scaling a program or strategy, while critical to long-term growth and sustainability, is challenging. Only about half of those health systems surveyed have achieved mid-stage virtual health maturity.

"To beat this catch-22 and scale well, LHS must conduct an honest assessment of their virtual health maturity by looking at key indicator performance such as governance, data and technology management, financial sustainability, and clinical integration—each of which represents a critical component to scale," the report says. "Organizational self-assessment across these maturity indicators can help health systems determine their readiness for scaling virtual health solutions. However, most LHS still have a long way to go before they will be ready to scale. They will need to focus on solidifying and planning for the governance, sustainable financing and more of their virtual health programs before attempting to scale across the organization."