With the sudden easing of restrictions by the government and equally sudden reimbursement from payers in response to the COVID-19 pandemic, it’s very clear telemedicine has never been more used or more vital. Hospitals and health systems have gone from dozens to thousands of telehealth visits per week.

Just as telehealth has never been more important, it’s never been more important for healthcare provider organizations to make sure their telemedicine technology is finely tuned so that patients are getting the best distance care and the organizations are getting the most out of their tech investment.

In this Healthcare IT News special report, telemedicine technology experts from Amwell, Caregility, Eko and emocha Health offer readers their decades of expertise in the form of best practices for optimizing the technology.

Scalable across use-cases and workflows

When implementing telemedicine programs, healthcare provider organizations will see the best results if they use technology that is scalable across a variety of use cases and can accommodate various clinical workflows, said Dr. Roy Schoenberg, CEO and cofounder of Amwell, a telemedicine technology and services company.

“At the beginning of the pandemic, many healthcare providers used telemedicine for urgent care needs and COVID-19 screenings,” he explained. “But as time has passed and healthcare organizations continue to adapt to a dynamic environment, there’s been a major shift from urgent care to scheduled visits, with patients needing to and wanting to use telehealth for regular care needs. This has driven hospitals and health systems to quickly expand their use of telemedicine to include behavioral health, chronic illness management, surgical follow-ups and more.”

"For these more complex visits to be successful, CIOs must also prioritize telehealth that is equipped to maintain rules of engagement for both patients and physicians."

Dr. Roy Schoenberg, Amwell

To optimize telehealth, CIOs need to ensure their telehealth technology can easily scale across different use-cases and can be made available to clinicians in a way that fits their individual and organizational needs. That way, providers can choose how they use technology to reimagine the way they practice medicine with their own patient populations, he added.

“Additionally, for these more complex visits to be successful, CIOs must also prioritize telehealth that is equipped to maintain rules of engagement for both patients and physicians, including the ability to discern who is the physician on the call,” he said.

Keeping up with concurrent session demands

If COVID-19 has taught provider organizations anything, it’s that telehealth systems that are quick to implement and easy to scale are the first and most effective line of defense, said Mike Brandofino, president and COO of Caregility, a telehealth technology and services company.

“Inflexible systems that couldn’t keep up with concurrent session demands – which went from the hundreds to several thousand almost overnight – hampered the ability for some providers to respond to the pandemic,” he noted. “A telehealth platform’s ability to support new integrations as well as increased volume over time directly impacts your organization’s ability to innovate and pivot.”

"A telehealth platform’s ability to support new integrations as well as increased volume over time directly impacts your organization’s ability to innovate and pivot."

Mike Brandofino, Caregility

Cloud-based systems offer flexibility, allowing one to access a centralized system from any endpoint equipped with an internet connection, Brandofino said.

“This overcomes many of the initial barriers and costs associated with hardware and software installations,” he said. “A cloud infrastructure lays the groundwork for future optimization as virtual care solutions grow to encompass new web-connected devices.”

Device and EHR integration are another key facet of that system flexibility, he added.

“Your ability to engage patients via the same portal they already use optimizes that experience for them as well as their clinician by reducing system sprawl and keeping things centralized,” he remarked. “Look for solutions that offer direct or API-enabled integration with your health system’s EHR.”

Adaptability is key

Improving patient outcomes is the primary goal of telehealth, and hospital and health system CIOs and executives should know there is no one-size-fits-all solution, said Jason Bellet, cofounder and chief customer officer at Eko, a telehealth, connected health device and remote patient monitoring technology company.

“For example, organizations with a large rural patient population benefit from using telemedicine to provide services typically not available in rural settings, such as sub-specialist outpatient care or acute care – for instance, a tele-stroke program to evaluate emergency department patients for stroke,” he noted. “Another center may use telemedicine to provide follow-up care to patients after surgery to eliminate the need for travel.”

"Telemedicine needs to be adaptable to the needs of the patient and provider; this means optimizing for different scenarios."

Jason Bellet, Eko

Telemedicine needs to be adaptable to the needs of the patient and provider. This means optimizing for different scenarios: reducing in-person visits, integrating data when necessary to inform clinical decision making, or improving access to care when mobility is impacted, he added. True optimization will be focused on patient-centered, adaptable care, he said.

Integration for a better user experience

When seeking ways to optimize telemedicine technology, CIOs should make sure the technology integrates with their existing systems – like EHRs – to create an easier user experience for the physicians, nurses and clinicians who use it, said Schoenberg of Amwell.

“Unlike many in-person visits, where providers typically have information about a patient’s labs, procedures and diagnoses in front of them when interacting with the patient, access to these details may not be readily available during a telehealth visit if the telehealth platform is not fully integrated with the EHR,” he stated. “Particularly now, with the rise in telehealth use during the COVID-19 pandemic, fully integrating your organization’s telemedicine platform with other IT systems is critical. Increased interoperability gives healthcare providers access to the full spectrum of a patient’s medical history, which, in turn, allows care teams to make informed and timely medical decisions.”

What’s more, seamless telemedicine integration makes for a better patient experience, he added.

“Patients can easily request refills, access and reschedule their appointments, and pay bills – all in one place,” he said. “Without an integrated telemedicine program, neither doctors nor patients have easy access to the information and tools they need. As a result, they may view telemedicine as a temporary ‘stop gap’ method of care and will have less of an inclination to use it after the pandemic.”

By taking a few extra steps to integrate telemedicine technology with existing systems, organizations can ensure that patients and providers alike will start to see telehealth as an inherent, sustainable part of healthcare overall, he said.

Invest in the patient experience

At all turns, patient care, not complexity, must remain the focus, said Bellet of Eko. This means spending time with patients to make them comfortable with using technology, whether it is video conferencing, downloading specific applications or using new tools that enable clinicians to get a clear picture of their health, he said.

“Populations like the elderly – where it has been so important to keep them at home – may be hesitant about using new technology, so it’s important to realize that you may need to spend extra time to walk them through the process,” he added.

Automation versus the human touch

When it comes to telehealth, healthcare providers must be discerning about what processes can be automated, and which aspects of service require a human touch, advised Sebastian Seiguer, CEO and cofounder of emocha Health, a telemedicine technology and services company.

“For example, at patient onboarding, providers are critical for explaining to their patients why using the technology will help their health, and making sure they understand how to use it,” he said. “While maintaining that human focus throughout the use of the service or technology is essential, implementation is a key point in the process during which high-quality, human-centered training will have lasting benefits for end users.”

"While maintaining that human focus throughout the use of the service or technology is essential, implementation is a key point in the process during which high-quality, human-centered training will have lasting benefits for end users."

Sebastian Seiguer, emocha Health

The next step, according to Seiguer, is engagement during the program.

“Remote patient monitoring assumes the near-daily capture of important patient data,” he said. “A healthcare provider must be prepared to review and react on a daily basis. If a provider cannot maintain this touchpoint using office staff, the telehealth solution will be less effective – as the patient will only use the technology if there is a feedback loop with the provider.”

In these cases, alternative business models are emerging, which allow providers to augment their team through third-party engagement teams, he noted. These types of mixed models should be carefully designed to present a unified patient experience and to achieve the end goal: an engaged and active patient who feels connected to their provider, he said.

Virtual observation

Another area where telehealth program optimization is really taking off is around virtual observation, said Brandofino of Caregility.

“These patient bedside systems can be portable wireless units or permanent installations that consist of a video camera and two-way audio that transmits to a central monitoring station,” he explained. “Each monitoring station can be staffed by a trained observer who typically watches up to 10 to 12 patients at a time, which drives workflow efficiency by freeing up clinical staff.”

This has proved invaluable to clinical staff trying to limit use of PPE and virus exposure during the pandemic, he noted. Healthcare is seeing innovation around optimizing these systems to even further reduce physical contact by offering patients auto-answering and one-touch dial-out features, he added.

“As health systems continue to optimize these platforms, we encourage them to let patient risk assessment and clinical data be the guiding light that illuminates new and better workflows,” he concluded. “Identify new patient sets that are ideal candidates for virtual observation, then engage their clinicians to uncover opportunities for condition-specific efficiency gains.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himss.org
Healthcare IT News is a HIMSS Media publication.