4 Keys to a Sustainable and Scalable Telehealth Platform
By Eric Wicklund
Virtual care may be an integral part of the so-called “hospital of the future,” but that doesn’t mean health systems and hospitals can just throw together any old tech platform and see it work. If you build it, they won’t necessarily come.
Like any new idea or technology, virtual care needs a sound business plan.
During Tuesday’s Winning Edge webinar, two healthcare innovation executives from two very different health systems explained in detail how they’ve made virtual care work for them and their patients.
For David Higginson, EVP and Chief Innovation Officer at Phoenix Children’s Hospital, the challenge lay in creating a sustainable telehealth platform that would meet the needs of their pediatric patients and families, improving clinical outcomes and long-term care concerns. For Stephen Hunter, VP of Digital Strategy and Innovation at the Allegheny Health Network, part of Highmark Health, a virtual care platform had to address immediate care needs for patients while creating a sound business model for the both the health system’s population and community health plans and the affiliated health plan’s members.
1. Don’t Fall for the Shiny New Thing. While the COVID-19 pandemic proved the value of virtual care, an even more important lesson learned for many health systems was that the biggest, flashiest technology solution isn’t always the best. Many providers were setting up simple, easy-to-use telehealth platforms on their own, using the most basic technology, and making them work.
Higginson noted that Phoenix Children’s set up a platform using a Zoom API in about three weeks, at a cost of about $12,000. And while that won’t likely work for most health systems eyeing a long-term program, it proves that the “flavor of the month” isn’t right for everyone. Healthcare leaders need to test out all the technology they can find, keeping an open mind and looking for what works for them.
Selecting the right technology also means looking at the long term. A tool or platform might be good for now, but will it still provide ROI in five years or be rendered obsolete by newer, better technologies? Will a health system become mired in chasing the next big thing or investing in upgrades that dilute or even destroy ROI?
The important strategy here is to be adaptable and flexible. Explore all the options, and understand that sometimes the simplest technology is the best. Plan on upgrades, but don’t think that every new thing has to be added to the platform.
Both Higginson and Hunter say a tech platform has to begin with a clear understanding of the problem that needs to be solved, and that means understanding what virtual care means to the patient. The technology has to be easy and intuitive for patients, allowing them to access care and services from their homes. If a provider needs to spend a long time explaining to patients how the technology works, chances of adoption are low.
It’s also important to make sure everyone involved in the new program, from doctors and nurses on to pharmacists and HIT staff, knows about all the features and capabilities. Sometimes a great new tool, such as online scheduling of medication refills, is wasted because staff don’t realize it’s there and they don’t tell patients that it’s available.
Finally, Hunter noted that patients usually want to be connected to their doctor, not just any doctor on the platform. It’s important to set up the platform so that doctors are working with their patients on a continuous care journey (a key component of the business plan is that this relationship captures downstream care opportunities). Don’t just connect any patient to any doctor and expect everyone to be happy.
It should not go unsaid that a platform needs to be seamless and stress-free for the provider as well as the patient. If your adding new tasks or steps to an already-stressed-out doctor or nurse, you might have a hard time getting them to buy in.
3. Balance Clinical and Financial ROI. Sustainability is a tricky mixture of hard and soft ROI. A great virtual care platform that addresses clinical needs won’t survive if it costs a lot of money. At Allegheny Health, Hunter noted that a virtual care platform can address the health system’s business needs to expand its patient base and pull in downstream services, like follow-ups and health and wellness services, all of which attract the attention of the health system’s associated health plan.
Higginson pointed out that gathering patient stories and anecdotes can be beneficial in more ways than one. They reinforce the health system’s mission, prove that virtual care is improving access to care and helping patients and their families, and can be used to prod payers and politicians to support the program. A few good stories could convince a senator or representative to take a closer look at how the state is legislating virtual care or reimbursement, two key barriers to telehealth adoption.
The biggest point to be made here is that ROI is a multi-faceted strategy. Immediate cost and value need to be balanced against long-term costs and benefits. The money spent on technology and staffing may very well be made back in long-term clinical benefits, such as reduced ER visits and hospitalizations, happier patients and less-stressed doctors and nurses. At the same time, a telehealth program that requires continuing tech upgrades so that it won’t become obsolete in five years is a bad investment.
4. Expect to Be Surprised. Few programs work out the way they were planned, and virtual care is certainly no exception. It’s OK, even imperative, to have a comprehensive strategy that maps out everything that could happen, right or wrong. Prepare for any eventuality, and then be prepared to be surprised.
For example, Hunter said Allegheny Health had expected that its virtual care platform would see success in addressing access issues in rural areas, but found that urban residents were using the platform much more frequently to access care that they had a hard time finding. Higginson, meanwhile, said Phoenix Children’s didn’t think much about adding a button to its portal to allow patients to request refills, then saw how much that button meant to patients and their families.
The upshot is that things sometimes work whether we plan that way or not, and it’s crucial for healthcare leaders to be prepared for that flexibility. That may mean shelving one virtual care platform and trying out another, or accepting failure and moving on quickly. It may also mean ditching assumptions or preconceived ideas about a technology or strategy and letting something play out a little bit to find its way.
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.