A Virtual Response to the Virus

Healthcare operations have been dramatically impacted by the COVID-19 crisis, as hospitals have been transformed to maximize capacity and safeguard patients. Hospitals are being repurposed to best mitigate the impact of the pandemic, and entire service lines have either been put on pause or transferred to a virtual setting.

Telehealth adoption has already been on the rise in recent years, and the pandemic has caused demand to surge at an unforeseen rate. Though telehealth has historically been positioned as an option of convenience, the COVID-19 pandemic is pushing this modality to the forefront of the healthcare dialogue as a critical, must-have tool for healthcare organizations.

In a discussion with Modern Healthcare Custom Media two industry leaders offered best practices around telehealth and discussed how it can be used not just as a differentiator but an essential asset.

Panelists:

Kathy Ford
President and Chief Product Officer
Rhinogram

Kathy Ford is president and chief product officer of Rhinogram. She is a healthcare industry veteran with 25 years of experience as an innovator and leader at GE Medical Systems, McKesson, Siemens Medical, Carestream Dental and NantHealth.

Jason Hallock, MD
Chief Medical Officer
SOC Telemed

Dr. Jason Hallock is chief medical officer at SOC Telemed, where he leads clinical and administrative strategy. He is a clinical and operational leader with over twenty years of experience in some of the nation’s most highly developed clinically integrated networks.

KF: Conducting virtual visits is crucial for business continuity during this crisis, especially when faced with disrupted operations and staff furloughs. Communication platforms that deliver telehealth capabilities and can engage patients in their preferred manner—such as secure text messaging or social media—allow providers to reduce phone call bottlenecks and reach patients more quickly, while securing the foundation for smoother workflows and better patient care.

JH: No one was prepared to virtualize this quickly. Virtualizing scheduled visits is fairly straightforward. Many outpatient clinics are using point-to-point solutions like Zoom. The more difficult piece revolves around triaging patients in real-time and managing surge. How do you efficiently deploy available clinicians to where they are needed in real-time? The real “magic” in telemedicine is in the virtual workflows.

KF: Providers must stay connected with low-acuity and chronic patients, even as facilities close and postpone elective procedures. This is where telehealth can be leveraged to triage patients’ physical and emotional health, through four key actions: condition identification, remote monitoring, limiting exposure and extending care to those with limited access. Telehealth offers customizable templates, smart routing and text-to-pay, further optimizing staff time.

JH: Telemedicine increases provider efficiency. Windshield time, idle time, geographic boundaries and even the time it takes a physician to walk down the hall are eliminated. Instead of covering a single facility across the course of a shift, virtual specialists can be deployed to any geographic location experiencing an acute need. Real-time, centralized visibility into clinician availability optimizes every minute of time.

KF: Telehealth extends care to those in rural settings, but there are limitations. For instance, video tele-consults and logging into an EHR portal might not be an option for those without reliable internet access. But cell phones are nearly ubiquitous. Providers must ensure telehealth implementations align with the technological capabilities of the patient population, as well as any integration requirements for existing EHR and billing systems.

JH: Telemedicine is already impacting rural health strategy. In the U.S., 48% of hospitals are “rural,” serving 84% of land but only 18% of the population. One challenge for many rural facilities is a lack of access to specialists which creates critical gaps in care. Telehealth can deliver specialists wherever they are needed allowing rural hospitals to continue providing critical care, stroke care and emergency psychiatry services around the clock.

KF: National telehealth providers are useful for patient overflow and after-hours care but are transactional in nature. For patients, it comes down to convenience which is why more physicians must leverage telehealth advances as a source for immediate care. Implementing a text and video communication platform means patients can stay connected to their physician rather than seek care from a national network with whom they have no prior relationship.

JH: The healthcare delivery model is changing faster than many physician practices can keep up. Patients want on-demand access to a doctor. They want care to fi t into their regular lifestyle. And they don’t want to wait. Widespread adoption of telemedicine will further accelerate this evolution. Primary care should take note.

KF: Telehealth protects high-risk populations and allows them to keep up with care plans. To ensure widespread access, providers must support virtual care with the lowest technology barriers possible: cellular service. The ACA made flip phones with unlimited texting available to any Medicaid patient. Further government support and full reimbursement for asynchronous communications (texting) will continue to drive adoption of this type of care.

JH: Connectivity is still an issue in many parts of the country. The poorest in our communities may have no connectivity at all. Today most older adults seem comfortable using smartphones, but they may not be as comfortable accessing telehealth programs or communicating with providers in this capacity. But, with facilitated care, family members, social workers, visiting nurses and caregivers can support telehealth access for vulnerable citizens.

KF: For interoperability, it should never be about who owns the data; but who needs the data to deliver the best possible care. Today, EHRs serve as the Fort Knox of patient information. And while that data needs to be secured, it also needs to be shared. The more we can interweave social determinants, patient histories and clinical episodes, while making that information accessible across platforms, the faster we’ll diagnose, prescribe and heal.

JH: It is really patients who will benefit most from the elimination of data silos and the safe transfer of information between providers. Having access to a robust medical history provides additional context for providers, improving their interactions with patients, eliminating the need for duplicative testing and preventing medication errors. In sum, interoperability supports better longitudinal care.

KF: While some telehealth advances—like video—can be limiting due to the expense and access reasons discussed in my prior answer, there’s still plenty of room for growth. But adoption will increase only in relation to telehealth’s ability to mirror the communication patterns of the user—be it traditional text, Facebook messenger, WhatsApp, Instagram or whatever follows. Healthcare must make faster strides to keep up with today’s generation of consumers.

JH: Telehealth offers the ability to tear down the four walls of the hospital and the physician’s office all at once. Of late, the speed of adoption has skyrocketed due to the COVID-19 pandemic, but we are still barely scratching the surface. Prior to COVID-19, telehealth accounted for just 1% of hospital care. As care continues to fragment toward the paths of least resistance, in the near future telehealth could account for more than 25% of care.

For more information about Rhinogram, visit www.rhinogram.com.

For more information about SOC Telemed, visit www.soctelemed.com.