Troy Yoder, global healthcare leader at Cisco, leads healthcare innovation at the company. He's has helped healthcare provider organization clients double down in the last year, especially on virtual care. He believes this is just the beginning for telehealth and that this style of healthcare delivery will only accelerate in growth and evolve in the years ahead.

Though many physicians and patients alike have been engaging in telehealth, Yoder believes there are some immediate trends and expectations healthcare will see from virtual care moving forward.

Healthcare IT News sat down with Yoder to discuss these trends and expectations and get him to offer an in-depth look at the future of telemedicine.

Q: In general terms, technology has paved the way for consumers to expect ease, convenience and efficiency. How will this affect healthcare delivery and the future of telehealth?

A: It starts with data – contextual, timely information that guides action. For hundreds of years, healthcare data was pen and paper housed in massive files in hospital basements that created a single picture of an individual patient's medical record and history.

The introduction of electronic health record systems introduced medical data mobility. No longer relegated to the basement, the data could be easily shared, aggregated and evaluated. Data was in the right hands at the right time and saved lives.

But the promise of data mobility stalled. The same government regulations intended to make data more portable and available became a hurdle to new healthcare delivery services. Faxes, pagers and CDs are still a primary technology for referrals, urgent communications and MRI exchanges.

Healthcare is the only industry I can think of that simultaneously regulates that data must be both protected and shared with fines for not complying with both. Concerns about HIPAA compliance have essentially led to technology stagnation over the last decade with IT weighing the risk of potential fines and security breaches to gains in efficiency and convenience.

Telehealth was disproportionately impacted as a technology. State and federal rules on delivering healthcare services over video were complicated and contradictory, holding back investment in virtual care.

And then COVID-19 disrupted that healthcare technology plateau we had been walking for the last 10 years. The hurdles and regulations that slowed technology progress were temporarily suspended. Video calls were adopted by consumers worldwide and telehealth exploded along with it. Chatbots delivered symptom triage, and for the first time healthcare became a technology-first experience.

When we needed care, it was now a call, click or chat. Where previously patients had been frustrated by a mismatch in their consumer experiences and their healthcare experience, they now used chatbots and voice recognition technology to schedule appointments. And it is timely contextual data exchange that makes the experience work.

The future of this healthcare technology revolution will rest in IT's hands as those teams will need to manage the applications, devices, data and workflow while balancing a significantly higher cybersecurity risk. A "healthcare anywhere" model is our future, where data can be simultaneously mobile, but controlled.

Q: You've told me that "the app-less experience" will be essential for widespread telehealth adoption. Please elaborate.

A: When I look at the future, patients won't be forced to download a new app or create a username and password just to meet with their doctor. Imagine if you needed legal advice but if you couldn't drive to their office, you needed a special app to have a consultation. Why is it any different for telehealth?

A no-download experience may even be more important across the globe, because many of them are earlier in the telehealth adoption curve. Human behavior is predictable, and adoption of any new process works best when the experience is simple, fast and clear. Even better is a new digital process that is a close replication of an existing physical process, because then it just feels familiar. We can anticipate the next step. Joining a video visit should be as simple as clicking a link.

Every generation likes to engage with technology in different ways. Healthcare technology needs to meet patients on terms they're comfortable with. Our data on customer interaction shows that if you need a four-page how-to document to start your telehealth visit, most people won't jump through those hoops.

For telehealth to be sustainable post-pandemic, it has to be better than it is today. Here are my five keys for sustainable virtual care adoption globally:

• Simple to support. Leverage technology IT knows, and that your CISO supports.
• Easy to connect. Almost every browser and smartphone today supports an app-less experience via webRTC. Patients are saying no to new apps and new passwords.
• Security built-in. Security can't be an afterthought when delivering telehealth at scale. Look for a solution that meets ISO 27001, 27017, 27018 standards at least.
• Reliable platform. Clinicians need to be confident it will work every time. And IT needs real-time visibility into connection issues and visit telemetry that will help them minimize frustrations for both providers and patients.
• Integrated into existing workflows. Providers and clinicians want a process they know and trust for patient care without jumping through technology hoops.

Q: The concept of the digital front door as a vehicle for patient engagement and population health is only in its infancy. What does it really need to do? And can technologies like artificial intelligence play a role here?

A: The way we are defining the digital front door is broad and encompasses digital collaboration across any channel between the care team and the patient, including picture and document exchange. Digital front door technology can positively impact almost every interaction that happens before a patient presents at the front desk and after they are discharged.

For patient intake, that includes scheduling and referrals, pre-op services, financial counseling, and revenue cycle. For post-acute, that includes digital services to assist with medication adherence, chronic-condition symptom management and more.

To realize the promise of a digital front door, technology must bring contextual intelligence, communication and data to the proper point of care. In most health systems, patient intake is a manual process, and interaction has largely been phone call focused. The rise in robocall and spam has limited trust in the voice channel, which means patients don't answer phone calls.

Clinicians leave voicemails, but this extends the communication process overall. We also find that patient portal adoption is low on average. The net result is inefficient communication between caregivers and patients.

Reimagining the patient intake process requires connecting the systems and applications to the patient data. Artificial intelligence and natural language processing will play a big role in accelerating efficiency and increasing the frequency of patient touch points both before and after clinical interventions.

AI can help gather relevant data by guiding a patient in an automated virtual triage exchange and then selectively escalate to an enterprise-scale contact center where skilled clinicians can pick up the interaction without losing any data in the process. 

Across the U.S., there is a shortage of clinicians in many service lines. If it isn't an emergency, AI technology can start a patient interaction digitally, freeing up short-handed resources for other tasks.

Digital front door technology, AI and NLP certainly have the potential to streamline the efficiency of patient intake. This in turn allows for more proactive scheduling communication, which increases schedule density and lowers the complexity of communicating with chronic condition patients.

And easier experiences lead to brand loyalty and patient satisfaction. We often talk about the goal of clinical resources operating at the top of their licensure. The digital front door is a powerful tool to help make that more of a reality in the coming years.

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