TELEHEALTH | PRECISECAREMEDICAL.COM

  Since its inception in 1897, “tele” health has been considered an avenue to offer care to avoid unnecessary office visits. In the early 1970s, NASA in partnership with the Papago Indians, further laid the foundation by developing remote healthcare techniques that are still used today. Since then, telehealth has found its stronghold primarily in rural settings to increase health and mental health access for patients.Telehealth_Start_Early_Days

 Now, due to the pandemic, the barriers to telehealth have all but collapsed. CMS temporarily expanded Medicare reimbursement and applicable services to broaden telemedicine options for all Americans. This expansion now allows for Medicare to pay for visits regardless of location, including within a patient’s home, and allows for a wider range of providers to offer virtual visits. Congress also appropriated $200 million in funding to healthcare providers to rapidly develop and implement virtual care programs within their hospitals.

 Telehealth, virtual care, and virtual waiting rooms have quickly become a win-win for both patients and hospitals due to the low cost for patients and increased market for hospitals. Hospitals have seen incredible transformations around virtual visits, with reports of over 1,000% growth. Carrot Health’s white paper Combating COVID-19 with Virtual Care and Predictive Analytics documents a leading telehealth platform that experienced a 3,600% increase in use over the first 11 days of the COVID-19 pandemic and over 400K total visits in March 2020 alone.

 As telehealth proves to be a cost-effective and safe beacon of hope for the patient that would otherwise not receive care, it is also a solution for hospitals to deliver care amidst overwhelming public concern due to the COVID-19 pandemic. Increasing access to care through telehealth seems to be a promising option for hospitals, according to an analysis from Advisory Board,

 “as many as 20 percent of virtual care patients would theoretically convert to being full-service patients of a hospital or health system at an estimated annual revenue increase of approximately $3,000 per patient.”

 Despite this benefit, however, there are still several concerns with the efficacy and implementation of a hospital telehealth or virtual care program.

 A common myth among critics is the concern of an impersonal patient experience due to the virtual environment of a telehealth visit. It is often assumed that because patients and providers are communicating through a video screen and that visits are briefer than your traditional in-person visit, a virtual visit will lack a feeling of human connection and cause issues with patient satisfaction. This is a myth; patients often have lesser feelings of human connection during an in-person visit than during a telehealth visit.

 According to GlobalMed’s Virtual Care vs. In-Person Visits: Which is Higher Quality?, during an in-person visit, 64% of primary care physicians did not ask why a patient came in, and when they did, patients were interrupted within 11 seconds. American Telemedicine Association CEO Ann Mond Johnson in ATA’s Johnson Looks to Dispel The 7 Myths of Telehealth Adoption, explains a different perspective “virtual visits – especially those used in telamental health – often compel patient and provider to look each other in the eye. As well, the telemedicine platform can improve interactions for patients who aren’t comfortable seeing a doctor in person.”

 While there is certainly a distance barrier and looking at a monitor can feel less human, there are a few practices that will help your patients feel as though they are speaking with a person and not a computer. According to Best Practices for Patient Engagement with Telehealth, providers can build rapport with their patients by interacting with them. A simple, “How are you doing?” can go a long way in building a human connection through a computer. Asking patient-centered questions about their goals for care in the beginning of the visit can open a healthy discussion between provider and patient. If the patient is new to the virtual visit experience, providers can educate them by discussing the aspects of the visit and virtual care, so they know what to expect and feel more comfortable. Making direct eye contact, actively listening, and not interrupting when the patient is speaking can all improve the patient experience during a virtual visit. In addition, creating a welcoming virtual care environment with quality telehealth-appropriate cameras, natural lighting, and room aesthetics as outlined in Part 4 Strategic Location, Environment & Hardware Considerations, can also improve the patient experience. If the patient less familiar with initiating a telehealth visit, which is a common barrier for elderly individuals, providers should take extra care to create an inviting environment and anticipate their needs, especially for individuals who lack experience with technology. By following these practices, you will make a considerable positive impact on patient engagement and the success of your virtual care program.

 According to a white paper from Fair Health, telehealth surged from 2016 to 2017 by a drastic 53%. Beckers Hospital Review echoes this finding in an article The business case for investing in virtual care by posing the question,

 “What if someone told you that if your health system leveraged the right type of virtual care platform you could add 2,000 new patients by offering a virtual care service line?”

 The article further states, “an analysis from the Advisory Board estimated that as many as 20 percent of virtual care patients would theoretically convert to being full-service patients of a hospital or health system at an estimated annual revenue increase of approximately $3,000 per patient.”

 Despite telehealth’s growing popularity, expansion was stifled by limits in coverage, payment, policy issues, and Medicare dictating geographic use and practice settings. However, with onset of the COVID-19 national public health emergency, immediate flexibility was created around telehealth to supply patients with safe access to care, thus boosting virtual care in 2020. Carrot Health’s white paper Combating COVID-19 with Virtual Care and Predictive Analytics documents a leading telehealth platform that experienced a 3,600% increase in use over the first 11 days of the COVID-19 pandemic and over 400K total visits in March 2020 alone.

 Hospital_Coronavirus_RecessionThe recent pandemic has undoubtedly placed historic financial strain on America’s hospitals, affecting both supply-side and demand-side as we head into a recession. According to the American Hospital Association (AHA), COVID-19 caused an estimated $202.6 billion in losses for America’s hospitals and healthcare systems in just a 4-month period. HealthAffairs, who analyzed the 2007 recession and its impact on the hospital finances in Hospital Financial Performance In The Recent Recession And Implications For Institutions That Remain Financially Weak, stated, “hospitals need financial resources now to implement changes in the delivery of health care so that they can start restructuring organizational programs and activities.” Hospitals need revenue to support projects for new types of care, such as virtual care, telehealth, and virtual waiting rooms. The upcoming financial struggles will certainly affect a hospital’s delivery system reform and value focused purchasing initiatives, so the question is…

 Virtual care is a good place to be. According to Brookings, a large reason healthcare funding shrinks during a recession is due to declining household incomes. Evidence shows a segment of the population simply avoids or puts off health care altogether, leading to lower health spending and obvious health risks for patients. With virtual health, doctors can meet patients where they are, increasing access to care. Furthermore, the lower cost of a virtual visit encourages patients to get the care they need, when they need it, and offsetting some of the negative financial and health impacts caused by a recession.

 As the new norm for health care shifts, virtual visits, virtual waiting rooms, and telehealth have become the “meet patients where they are” solution hospitals need. This abrupt demand, however, has left many hospitals wondering where to begin. Fortunately, The National Consortium of Telehealth Resource Centers has provided a step-by-step guide with questions to consider as you plan , as well as a sample business proposal that you can view HERE.

 There are several grants available for virtual care programs as well as various resources surrounding COVID-19, which you can explore by clicking the links below. When you search these databases, be sure to include various phrases such as “telehealth” or “COVID” to maximize your opportunity for funding

 COVID-19 Telehealth Program – In April 2020, the FCC released $200 million in emergency funding for the COVID-19 Telehealth Program for eligible nonprofit and public health care providers to help offer connected care services to patients at their homes or mobile locations in response to the COVID-19 pandemic. At present, there is still $90 million in funding available.

 Health Resources and Services Administration Telehealth Programs – The Office for the Advancement of Telehealth (OAT), provides a list of active and inactive grants.

Virtual Care

 Telehealth Resource Centers – Choose your state to contact your telehealth resource center for state-specific funding opportunities.

 Building_telehealth_teamAs your hospital considers telemedicine as a means to deliver expanded and convenient healthcare, it is important to gain an understanding of the key players in a virtual care program and the optimal team structure for successful implementation before moving forward.

 In the following section, we will address the importance of a clinical champion for your virtual care program and provide the key qualities and roles of a successful telehealth champion. Guided by research from AMA, we will also explore telehealth team structure, as well as the roles and responsibilities within a virtual care implementation team and telemedicine staff and care teams. We will conclude with a definitive array of best practices and training resources, answering questions such as:

 A telehealth or virtual care champion, sometimes known as the clinician champion, is the rudder that steers as well as the sail that propels virtual care implementation and improvement operations. Champions are enthusiastic individuals who promote and support your virtual care program. They wholeheartedly believe that a virtual care program will benefit the organization, improve patient care, and increase healthcare access for those who would otherwise not receive care.

 In a whitepaper by Northwest Regional Telehealth Resource Center, comprised of hospital surveys addressing identification and development of telehealth champions, one respondent commented,

 “My experience has been that the clinical champion believes in the value of telemedicine for health care delivery. Having said that, the secret is to convince clinical staff that this is a win/win situation for both the patient and provider. Administration is ultimately responsible for thoughtful development and implementation of telemedicine services. If done properly, the clinical staff is engaged in an efficient and effective healthcare delivery model that benefits patients, providers and the organization as a whole.”

 A champion will often reveal themselves during the initial phase of telehealth considerations by consistently pushing the need for a telehealth strategy. Sometimes telehealth champions develop over time, as Eugene Somphone, MD, says in the Healthcare IT News article, Telehealth heroes: meet the physician champions of video visits,

 A champion will often reveal themselves during the initial phase of telehealth considerations by consistently pushing the need for a telehealth strategy. Sometimes telehealth champions develop over time, as Eugene Somphone, MD, says in the Healthcare IT News article, Telehealth heroes: meet the physician champions of video visits,

 “I was initially drawn into telemedicine, not by choice, but because our health plan decided to offer the service as an embedded benefit,” he said. “However, once I learned more, I immediately recognized the tremendous potential in terms of convenience, access and cost. I wanted to be on the forefront of this revolution in healthcare.“

 In either case, key champion characteristics are essentially the same, and a consistent theme that consistently draws in champions is seeing the immense value in improving patient health care delivery virtually.

 Upholds and educates staff on the core values of the telehealth program for the organization

 Networks with hospitals, clinics, other virtual care champions and telehealth support organizations to gain and share industry knowledge and resources

 Coordinator and communicator of virtual care needs between departments, including clinical staff, IT and management

 During the implementation phase, you will want to carefully select the members of your care team. Though it is completely dependent on your hospital’s needs, according to AMA, care team and staff members for telehealth often include the following Telehealth Clinical Roles and Responsibilities.

 Is familiar with telehealth and suggests virtual care as an option to patients when appropriate

  Front Desk Staff / Scheduler

 According to the AMA’s Telehealth Implementation Playbook, which includes a vast amount of helpful resources such as worksheets, guidance on team engagement, kickoff meeting agendas and more, telehealth strategies should organize their stakeholders into four distinct teams for implementation: core, leadership, advisory, and implementation.