As more health systems avail themselves of the quality, cost and access benefits that come with telehealth, IT leaders naturally have big questions about how those major investments in technology infrastructure, reshaped clinical strategy and staffing changes should be paying off.

A new study from Manatt Health Strategies offers perspective, drawn largely from two case studies of different care providers, about how the return on investment should be assessed for nascent telehealth deployments.

WHY IT MATTERS
The report shows that conceptions of comprehensive telehealth ROI will vary widely across organizations and depends on an array of factors unique to each provider: size, type, clinical capacity, payment model to name just a few.

Given that virtual care investments are "highly dependent on the institution’s objectives, as well as the estimated financial impact of the telehealth program," Manatt Health's new framework is meant to help healthcare organizations calculate predicted financial impact of specific deployments.

"Provider organizations should assess a potential telehealth program’s impact on value by evaluating the program’s impact on improving revenue, health outcomes and patient experience relative to cost," according to the report, authored by Mannat's Jacqueline Marks, Jared Augenstein, Anthony Brown and Sol Lee.

"In addition to the direct economic drivers, telehealth programs can generate value in a number of ways that may be difficult to measure," they wrote. "These include increasing access to care, allowing patients to receive care in more convenient settings, and improving patient and provider satisfaction."

THE LARGER TREND
The most fundamental variable in how a virtual care program should be judged is the kind of provider that's implementing it.

Academic medical centers, for example, "typically have a highly specialized workforce that treats high-acuity patients across a wide range of clinical domains," said the Manatt researchers. "In contrast, many community hospitals are smaller, have a more generalized workforce and may not provide comprehensive services at all hours of the day."

The reports authors listed some key questions that C-suites at each type of organization should be asking themselves:

• Academic medical centers ("Can we extend specialty and subspecialty expertise beyond our four walls via telehealth? Can we employ telehealth tools to improve care coordination, patient engagement and ongoing health management?")
• Integrated health systems ("Can we utilize telehealth services to reduce per-member health expenditures? Can we leverage AI-driven triage tools to navigate patients to the most appropriate site or method of care?")
• Community hospitals ("Can we offer additional specialty services and reduce avoidable transfers by partnering with local tertiary or quaternary hospitals for virtual consults? Can we increase patient retention by offering direct-to-consumer telehealth services for low-acuity conditions?")
• Primary care clinics ("Can we extend primary and preventive care to remote and vulnerable populations through telehealth services?• Can we better connect our patients to behavioral health and specialty care through virtual visits while they are in rural clinics?")

Other essential considerations that affect the lens through which telehealth ROI should be viewed, according to the report: patient acuity mix, potential for cost savings, new-patient volume and patient retention levels, hardware and software costs, program management requirements and staffing levels.

ON THE RECORD
"Providers are leveraging telehealth to optimize delivery of care, reach patients in remote locations, and improve care quality and overall patient satisfaction," said Manatt researchers. "Healthcare institutions should anticipate that for the time being the most significant financial benefits from telehealth programs are likely to be the result of changes to patient acuity levels and increases in new or retained patient volume, rather than the result of increases in reimbursement.

"Telehealth adoption is still in its nascent stages in the United States, and the overall evidence base is still limited," they added. "However, healthcare leaders can use the framework detailed here to reasonably estimate the ROI of telehealth programs to evaluate the merits of implementing and scaling telehealth activities."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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