When the COVID-19 pandemic began to spread around the country, health systems had to pivot quickly – many within a few days – to respond to the skyrocketing need for telemedicine.

For some, this meant there wasn't time to think deeply about which vendors were best suited to their needs; it was a question of speed and necessity.

Although the specifics are still fuzzy, it's been made evident that telehealth isn't going anywhere. Now that we've all had half a year to get used to the idea, the advantages of the modality are clear, as are the areas in which it still needs to improve.

Chief information officers undoubtedly are some of the best informed when it comes to the ways that innovation could fill existing gaps in virtual care. Fourteen IT pros told Healthcare IT News what they'd like to see from telehealth platforms in the future. 

"We moved so quickly on telehealth" that there wasn't really time to consider optimal features, said Scott Krodel, CIO at West Tennessee Healthcare, which had to rapidly scale up its virtual care offerings as the pandemic flared in the region.

"As we move more and more into remote monitoring, we'd love to see remote monitoring tools tied into the telehealth app," said Krodel. At this point, he said, "if the patient's trying to show us something we're turning our head from side to side." 

Tanya Townsend, CIO for LCMC Health in New Orleans, raised real-time monitoring as an ideal addition too: "Continued advancement in real-time monitoring of vitals from home that can trigger immediate response or alerts" is a feature she said she'd love to see.

"For telehealth, the one thing that video cannot fully replace is the physical aspect," argued Steven Smith, CIO at NorthShore University HealthSystem in Evanston, Illinois.

"That said, a fully integrated, easy-to-use medical device which can take and analyze blood, et cetera – above and beyond today's pulse, temperature, oxygen [measuring devices] – will help bring telehealth to the next level," said Smith.

Other experts raised the importance of patient engagement – a vital component of care that sometimes proves challenging in a virtual setting.

"If this were a perfect world, there would be complete patient engagement with video conferencing," said Novlet Mattis, chief information officer at Orlando Health. 

"The capability would exist for patients to fully interact with the shared screen to do everything from making selections, to asking questions, and even to drawing something on the screen as part of a counseling session," Mattis continued. 

"I would be simply elated if patients could rotate radiology images as they appear on screen in illustrating a specific area of concern during a discussion with their oncologist or surgeon," she said.

Mattis raised the possibility of using artificial intelligence and machine learning to streamline user experience.

"Imagine the use of more advanced AI bots to act as a nurse triaging the patient before it’s determined that a provider should join the call," Mattis said, with "fewer preset questions and a more conversational exchange. 

"When I chat with 'Sally Bot' on a video visit about my wound, it would feel as if I’m really having a two-way conversation with a nurse. Sally Bot can then tell me if I should go to the ED, or she will bring my provider into our conversation," Mattis proposed.

"Even more, this opportunity would be a great feature for pediatric telehealth platforms. Think about it: Wouldn’t kids feel more comfortable answering questions from the Peppa the Pig character on the screen rather than a pediatrician?" she continued.

"Methodist Le Bonheur Healthcare was already in the process of expanding its telehealth program when COVID-19 began to impact our community. We sped up that expansion to better serve our patients from the comfort of their home," said Tim Gates, acting CIO at the system headquartered in Memphis. 

"It would be wonderful if the interface of telehealth was more user-friendly," he said. "Some patients have difficulty navigating the technology for their health appointments."

Related issues around language barriers have frequently arisen when discussing accessibility, and Raymond Lowe, CIO at AltaMed Health Services in Los Angeles, had one prospective solution.

"At AltaMed Health Services, we serve a primarily Latino and multi-ethnic underserved patient population," Lowe explained. 

"What we need is an integrated voice translation service that is not reliant on Google voice translation – a natural language translation that allows the provider to speak in English and allows the patient to hear their preferred language, and not a machine translation," he continued.

St. Jude Children's Research Hospital CIO Keith Perry also pointed to accessibility issues: "I would like to see ubiquitous access to high-speed Internet and technical support regardless of physical location or economic situation for telehealth."

And for patients whose support systems may not be based in their own home, Jason Joseph, CIO at Spectrum Health in Grand Rapids, Michigan, said it would be great to have a "'remote help' feature that would allow family members or others to join and help be part of the care process." 

"So much assumes these are one-device to one-device workflows," Joseph said.

On the clinician end of the interaction, Aaron Miri, CIO at Dell Medical School and UT Health in Austin, Texas, said he'd welcome the ability to have multiple providers for one patient.

"Virtual Integrated Practice Unit consult rooms" would give clinicians "the ability to allow multiple providers to see a patient at one time, document/chart respective to their subspecialty, and thus give the patient the opportunity to have a total healthcare experience," Miri said.

Similarly, Jamie Nelson, CIO at HSS in New York City, raised the idea of a "multidisciplinary group chat."

"Wouldn’t it be great to have your internist, your cardiologist and your nutritionist all speak to you simultaneously about a health problem that is best solved with input from several clinical viewpoints?" she asked. "A true clinical conversation!"

"It would be great to have a voice recognition feature so that as the provider is doing the visit and speaking with the patient/parents, the visit note is automatically being captured and transcribed into the electronic health record," suggested Lisa Grisim, VP and associate CIO at Stanford Children’s Health. "The provider can go back into the EHR afterwards and just edit and sign it.

B.J. Moore, CIO for Providence in Renton, Washington, said he'd "like to see seamless integration of telehealth tools into a caregiver workflow and experience."

"It would be awesome to embolden telehealth with technologies like augmented reality and real-time predictive analytics, completely recognizing the power of data," said UPMC Chief Information Officer Ed McCallister. 

"By leveraging the full abilities of analytic insights with sensory and IOT data displayed on an electronic 'clinician cockpit' during a telehealth session, the timeliness, efficiency and ultimately positive patient outcomes would be taken to a new level," he said.

And when asked "what telehealth feature would you most like to see?" Tressa Springmann, CIO at LifeBridge Health in Baltimore, responded, "Why have to choose?' 

"A digital journey should afford synchronous, asynchronous, with voice, with video, with physiological monitoring, all in a single tool," Springmann said. "The elements of the tool that are enlisted will depend upon patient choice and clinical need. Today, these are many (largely) different tools."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.