When South Carolina health system Palmetto Health set out to create a telemedicine program at the six-hospital organization, they found that getting all the stakeholders on the same page to launch such a thing was no easy task. At the HIMSS Media Pop Health Forum Monday in Boston, Chief Value and Informatics Officer Tripp Jennings and Telehealth Manager Amelia Bischoff described some of the challenges in creating a working, cost-effective system.

A lot of the issues Jennings and Bischoff described were breakdowns in communication or priorities, internally or externally. Initially, they found that physicians were excited about telemedicine — but they wanted to create it in silos, pertaining to their particular specialties.

[Also: Palmetto Health exec on overcoming telehealth funding and physician reimbursement challenges]

“We’re trying to get away from the one or two physicians that really want to build telehealth for one disease,” Jennings said. “We cannot operate that, it’s too expensive. If you let the physicians run it, that’s what happens. Tele-whatever disease, Tele-another disease.”

  Read more of our read our event coverage

To address that problem, they worked with all the physician leaders to create a rubric of telehealth priorities for the whole organization.

“Your senior leadership needs to adopt telehealth and build it into the structure,” Bischoff said. “One of the things that we do continue to struggle with is the disconnect between our senior leaders and those people who are boots on the ground. That’s built into our strategic plan, not only educating patients, but our internal teams as well.”

[Also: Don't expect politics to derail population health, value-based care]

Bischoff and Jennings also ran into trouble with external politics. The health system was lucky enough to receive funding from a state grant program called the South Carolina Telehealth Alliance. But, in order to promote interoperability, SCTA put restrictions on what Palmetto could launch that sometimes proved to be more trouble than they were worth. In Jennings’s words “they helped us to death”.

Ultimately the health system has managed to create a few different telehealth programs, including some cart-based specialty programs and an asynchronous, direct-to-consumer telehealth platform. The problem with carts was standardizing them as much as possible – but not too much since too many carts added expense and contributed to physician burnout – but some specialties do warrant specialized equipment. Jennings thinks this problem will go away before too long, as more and more telemedicine moves away from specialized equipment to commercial mobile devices.

The direct-to-consumer program was also hampered by internal problems, this time a lack of communications with the marketing department which, after a budget cut, pulled the plug on promoting the platform.

“You can’t build a plan that doesn’t include marketing, especially for virtual care,” Jennings said. “When you build a new building, at least people can drive by, but there’s no way for them to find out about a virtual care offering. When you have something that’s so consumer-focused and you don’t tell consumers about it, you screwed up.”

  Related articles from our Pop Health Forum Coverage:

• Healthcare policy 'a mess,' so IT execs need to stay prepared
• Don't expect politics to derail population health, value-based care
• To break down telehealth silos, connect senior execs with the doctors on the ground
• Should IT or doctors lead population health programs? It's not so clear cut
• 4 population health must-haves: goals, leadership, organization, analytics
• You don’t need 30 products for population health
• Why healthcare innovation needs to become routine
• To fix broken US healthcare system, deliver value, VA director says

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