In the rush to quickly deploy virtual care programs during the pandemic, basic processes were sometimes overlooked. Experts say now is the time to take corrective action to ensure long-term success.
In the quest to roll out telehealth initiatives to meet the needs of patients during the pandemic, many health systems rapidly launched solutions. There is nearly universal agreement that 2020 catapulted virtual care several years beyond strategic timelines.
While many health systems are looking into the future to determine how to continue acceleration of virtual care, experts say it is also essential to hit the pause button. To ensure long-term success, organizations should assess whether they are delivering the best experience, determine how telehealth fits into the overall care delivery model, and examine the role trust plays in their endeavors.
1. Improve The Consumer Telehealth Experience
Throughout 2020, telehealth experienced phenomenal growth, according to FAIR Health, an independent, nonprofit organization that tracks commercial insurance claims as part of a healthcare cost transparency initiative.
In November 2020, the most recent month for which data is available, usage of telehealth increased by 2,938%, compared to the same month in 2019. Telehealth services comprised 6.01% of all "claim lines" processed by the payers the organization tracks, compared to 0.20% the previous November. FAIR Health defines claim lines as an individual service or procedure listed on an insurance claim.
These statistics reflect the solutions health systems aggressively launched at the beginning of the pandemic. Some organizations trained thousands of providers in a compressed time frame.
While consumers and providers quickly adapted to virtual care, their experiences were not flawless. Some patients had difficulty downloading and using apps, others had connectivity issues. Some physicians became adept at guiding patients through these processes.
Because of the extraordinary circumstances during the crisis, "People would accept a less than optimal experience," says Brian Kalis, MBA, managing director of digital health and innovation in the health practice of consulting firm Accenture. Don't expect that goodwill to last, he cautions.
"Consumers really are looking for a good digital experience," says Kalis. In a pre-pandemic survey about telehealth, "50% of people stated that a bad digital experience can ruin their entire experience with the provider and will even drive switching" to another provider, he says.
Now is the time to hit the reset button and determine whether additional training is necessary, say the experts.
"We've heard a lot about the need for more education and training," says Ann Mond Johnson, MBA, MHA, CEO of the American Telemedicine Association (ATA). And it's not just for providers.
Consumers "are at different levels," Mond Johnson says. "Some folks are scared, and others are fearless. You have to [remember the] whole mantra of meeting people where they are virtually, digitally, or in person. However that plays out, you have to recognize where they are in their own journey."
2. Examine How Telehealth Fits Into the Care Delivery Model
"Out of necessity during COVID, many health systems used multiple telehealth platforms in order to meet the need and the demand at the moment," says Kalis. "What we're starting to see health systems do now is step back and think through what strategic platforms they need for telehealth going forward."
Part of the equation is integrating virtual care into the overall care model; another component is determining the most effective workflow for clinicians and consumers.
"Think about how you blend virtual and physical environments together as part of how care is delivered," he says. "There's the opportunity to make virtual health not a standalone solution, but something that is integrated into traditional modes of care."
To permanently transition from physical-based encounters to a model that blends digital and physical experiences together, Kalis has the following recommendations for health systems:
- "Think of designing services that matter," he says. This means considering the consumer's and clinician's needs first, and then "backing into creating a solution."
- Determine how virtual care fits into a clinical practice and into the context of how a clinician prefers to work.
- Keep accessibility in mind. This includes bridging the digital divide, making sure people have access to technology, and ensuring equity in that access, "so we don't create more disparities as we shift towards new models," says Kalis.
The latter issue could be addressed through education, says Mond Johnson. "In many instances, on the consumer side, it's an issue of digital literacy," says Mond Johnson. "You can have all the connectivity in the world, you can have all the devices in the world, but if the end user isn't able to make it work—if it's not easy—then they're not going to get the benefit from it."
3. Focus on Building Trust
Before COVID-19, a growing barrier to consumer acceptance of telehealth was lack of trust, according to Kalis. Concerns were related to how an individual's data is being used, as well as apprehensions about security.
The past year did not deliver any reassurances. A report recently released by cybersecurity firm Tenable indicates healthcare accounted for the largest share of publicly disclosed data breaches in 2020 (25%), with nearly 8 million records exposed.
One key element in building trust is addressing data security. "Organizations need to make sure that they are buttoned down in terms of privacy and security, and cybersecurity in particular," says Mond Johnson. During a recent ATA conference, she says, "One thing that we heard was that cybersecurity is a patient safety issue. If you're going to get maximum value, you have to do everything possible to mitigate risk."
Interestingly, the pre-COVID Accenture survey noted a curious trust issue trend unrelated to cybersecurity.
"We saw trust in technology companies as a steward of health data was falling, but we also saw that there was a decreasing trust in physicians specifically, which historically receive a high degree of trust," says Kalis.
"It's critical for organizations to think through how to both build and sustain trust," says Kalis. He offers three recommendations:
- The first step is to "leverage the strength of the patient-clinician relationship," he says. Based on data that indicate these trust levels may be declining, it's necessary to simultaneously reinforce relationships with nonphysician members of the care team, Kalis says.
- Second, build transparency into every aspect of communications, including how the organization protects data related to telehealth services. "Trust can be earned by being transparent and accountable," he says.
- Third, "Make doctors key to promoting digital engagement and awareness," says Kalis. Before the pandemic, "a majority of consumers wanted clinicians to recommend digital solutions to help them manage their health and healthcare, yet only 11% were receiving those recommendations."
COVID changed that dynamic. "Now, out of necessity," says Kalis, "clinicians were recommending digital health solutions to keep people safe in their homes and also maintain their health." For virtual care to continue thriving beyond the crisis, providers need to continue to play an active role in recommending it, he says.
“There's the opportunity to make virtual health not a standalone solution, but something that is integrated into traditional modes of care.”
Brian Kalis, MBA, managing director of digital health and innovation, Accenture
Mandy Roth is the innovations editor at HealthLeaders.
Health systems should revisit telehealth training and education for physicians and consumers.
To position telehealth for long-term success, it's essential to determine how virtual care fits into the overall care delivery model.
It is paramount to build consumer trust, particularly as concerns about privacy and data breeches are growing.