Why providers must embrace telehealth now

Providers must prioritize telehealth applications that solve their own strategic problems. Covid-19 has demonstrated the versatility of telehealth to address problems of access, convenience, adherence, and engagement. These problems all appear in different forms and combinations for individual providers. The possibilities of telehealth are many, but so are the potential solutions.

Sample strategic objectives that could be addressed through telehealth

• Would virtualizing some maternal-fetal medicine appointments help attract busy professional couples and grow market share?
• Would expanded telehealth access reduce unnecessary ED utilization for Medicare oncology patients and limit total cost of care under the Oncology Care Model?
• Would select virtual visit types help meet goals for patient engagement and retention?
• Would virtualizing some touchpoints in a patient journey improve quality or satisfaction metrics?
• Would virtual visits with pharmacists, care managers, or other care team members improve adherence for patients with chronic conditions?

Goals that emerge from strategic, bottom-up assessments are more likely to be attainable and valuable than top-down goals, which ignore the realities of specific conditions and specialties, patient populations, and clinician uptake. Advisory Board’s modeling of the clinical feasibility of virtualizing ambulatory procedures at the specialty level shows enormous variability. The percentage of visits that could shift to virtual channels from in-person care ranges from 6% to 88%, depending on the specialty. Most specialties fall within a narrower, but still variable, range of about 15% to 40%.

To establish a baseline expectation for what proportion of visits could be done virtually at your organization, both overall and at the specialty level, download our Virtual Shift Estimator tool.

Training clinicians in the effective use of telehealth is essential for care delivery, patient experience, and clinician satisfaction. The differences between virtual and in-person interactions must be acknowledged and mitigated. Fluency with both technology (including tasks like launching the visit and capturing notes) and virtual “webside manner” (including demonstrating empathy and attentiveness) requires deliberate and ongoing investment.

However, clinicians will not embrace telehealth as more than a stopgap alternative to in-person care if they are not actively engaged in realizing its value or applying it as a solution to problems of care delivery. Less than three months after the initial wave of Covid-19 hit the United States in March 2020, many providers had reverted to performing as many visits in-person as possible. The familiarity of in-person interactions and the design of care delivery systems—including compensation—around that model can’t be overcome with how-to training alone.

Provider organizations need to articulate a value proposition for telehealth that reflects both the reality of what clinicians can do in a day and the objective to provide high-quality care.

Sample potential drivers of value from telehealth for clinicians

• Broadened opportunity to work from home or remotely
• Deepened understanding of patient’s home or social contexts
• Rightsized attention and time for patients based on complexity
• Sustained adherence to treatment
• Streamlined and faster documentation (asynchronous and ambient technologies)
• Increased throughput and/or productivity
• Improved access for patients

It’s important to note that Advisory Board’s conversations with physicians and physician leaders indicate that a value proposition oriented heavily toward costs or growth are not persuasive on their own. A focus on the benefits of an expanded catchment area or potential to reduce overhead are not likely to motivate frontline physicians to embrace telehealth.

Seize insight from your own data on telehealth

Providers should collect and evaluate data on their utilization of and patient experience with telehealth. This information is essential to establishing and validating any value proposition for telehealth.

Unfortunately, most provider organizations have limited experience with telehealth and little data on value, quality, experience, or cost. The recent surge in consumer interest and the current window of expanded reimbursement offer a rare opportunity to collect firsthand data on providers’ own patients and experiences with telehealth to inform future investments and decision-making.

Providers can support patients by helping patients understand the availability of virtual care and helping them access it. Patients are more likely to use telehealth when it’s just as easy as in-person visits. Advisory Board’s 2020 Consumer Survey found that about two-thirds of patients would choose a virtual visit over an in-person visit if they had to wait at least one day to see their provider. There are three things providers can do to help patients with telehealth.

1. Segment and prioritize patients.

Providers should segment their patient population to identify the patients who would benefit most from telehealth services—especially those who can’t access care otherwise. Telehealth won’t be right for every patient, just as it’s not right for every type of visit. Targeting patients ensures the patients are a good fit for telehealth and helps preserve clinical capacity for the patients who absolutely need in-person care.

Patients to target for telehealth include:

• Frequent no-shows for in-person appointments
• Those with limited access to transportation
• Those whose work schedule prevents them from accessing in-person office hours
• Those in at-risk populations for exposure to coronavirus

2. Raise awareness and steer utilization.

Let patients know that telehealth is an option and how they can access virtual visits. Different segments of the population will need different levels of outreach. Some patients just need to know telehealth is an option and that’s enough to spark their interest. Others need intensive outreach and handholding to get them on board.

Channels for increasing awareness and utilization of telehealth include:

• Promoting virtual visit options prominently on your website’s main page and/or patient portal
• Push notifications via email, text, social media, and other direct-to-consumer channels
• Making telehealth the default for simple or routine visits, like follow-ups and prescription refills

Some segments of the patient population will require more dedicated outreach to assure them that they can receive quality care with a virtual visit. Elderly or rural populations are prime candidates for telehealth because they’re often in need of increased access to complex and chronic care. However, these populations tend to be less tech-savvy and uneasy about the prospect of virtual care. These patients will need targeted outreach, where a member of the staff reaches out to them to explain the benefits of telehealth. They might require more follow-up work in preparation of the visit, such as help obtaining tablets or education on digital literacy.

3. Provide visit and technology support.

It’s important to support patient access to virtual visits—especially while telehealth is still relatively new. The key to success: complete as much of the pre-visit support at the point of scheduling as possible. Providers should also consider establishing a virtual “rooming” procedure where staff prepare patients immediately before the visit and follow up with them afterward.

Pre-visit responsibilities handled by technical support or other non-clinical staff can include:

• Helping the patient set up the required technology, such as downloading appropriate apps
• Preparing the patient for the visit by reminding them to find a quiet place to conduct the visit and answering any questions they have
• Collecting registration information and letting patients know how the virtual visit will run
• Keeping technology support on hand in case a problem comes up during the visit
• Following up with the patient to complete next steps and collecting information about any difficulties experienced during the visit

A smooth and enjoyable experience, especially when it’s the patient’s first exposure to virtual care, is essential to sustain their openness to telehealth.

For insight on creating a superlative virtual patient experience, download “Meet the Rising Bar for Virtual Patient Experience.”