As the novel coronavirus (COVID-19) has taken an unpredictable course, it has rapidly halted the economy, strained hospital resources, and infected hundreds of thousands of people, sending health systems reeling. In response to COVID-19, healthcare organizations have had to prioritize caring for COVID-19-positive and critically ill patients over non-emergent procedures (e.g., joint replacements and cosmetic surgeries) and routine care.
The reduction in non-emergent procedures and routine care has decreased access to care for patients and placed a financial strain on healthcare organizations. Health systems can help compensate for these setbacks through telehealth—the virtual delivery of care through digital platforms, including Facetime and videoconferencing (e.g., Zoom and GoToMeeting).
As outpatient visits have dropped due to the coronavirus, health systems have had to be nimble and find new, innovative ways to deliver care. Telehealth is one way health systems have responded to these new care delivery challenges.
Healthcare organizations already using telehealth, such as Ochsner Health in New Orleans, have seen a dramatic increase in telehealth visits since the U.S. coronavirus outbreak started at the beginning of 2020. For example, Ochsner Health’s virtual visits increased 933 percent during February 2020, and the number keeps climbing.
In the past, tight government restrictions have made it difficult for health systems to deliver telehealth. However, in response to the outbreak, the government has eased telehealth regulations, including billing for telehealth, because of the need for health systems to continue delivering non-emergent, routine care to patients. With relaxed restrictions, more health systems can provide services via telehealth to patients in their homes.
The new relaxation of rules triggered an increase in the number of health systems providing services via telehealth and, in turn, the benefits. The Centers for Disease Control and Prevention (CDC) have asked the public to stay home and social distance—especially if they think they may have contracted the virus—to limit the spread of COVID-19 and protect communities. Telehealth allows people to access healthcare while adhering to the CDC’s guidelines.
If health systems can learn how to effectively deliver services via telehealth during the COVID-19 crisis, they may begin to see telehealth as a viable way to deliver care moving forward. Telehealth helps attract and retain new patients and reduce appointment cancellations—all of which will be vital to a health system’s recovery after COVID-19 and telehealth success when the crisis is over. Telehealth is a valuable tool because it benefits both patients and health systems—patients can access care from outside the hospital, in keeping with social distancing guidelines, and health systems can generate patient volume and revenue.
Telehealth solutions also allow employers to improve access to care while cutting costs. Some companies incentivize team members to use telehealth tools—such as a virtual nurse or doctor’s visit—before resorting to urgent care or the emergency room, as telehealth options are a cost-effective option for patients and providers. Telehealth can reduce the cost of care for self-insured employers, their team members, and their health plans while increasing access and convenience for patients.
While telehealth is an effective way to deliver care to people in different places, health systems face challenges when trying to provide care virtually. As health systems have attempted to scale telehealth solutions in a short timeframe to meet the care needs of patient populations, typical obstacles still stand in the way, even with the easing of government regulations.
Although the decrease in non-emergent, routine care is a strong incentive for health systems to provide telehealth services, the process still presents challenges for health systems:
Although the challenges that come with telehealth are ever present, health systems can see that the telehealth benefits (e.g., access, revenue, and patient engagement) still outweigh the downsides. With the right tools and increasing demand for telehealth services, health systems can effectively deliver care to their patient populations without sacrificing quality.
The Health Catalyst® Financial Impact Recovery: Ambulatory tool helps organizations look at the impact of telehealth, track telehealth volume, and measure return on investment (ROI). When health systems understand visit ratios and the cost implications of telehealth visits, leaders can evaluate if the outpatient healthcare (delivered via telehealth) is financially viable. If the care is not feasible, the health system will know this immediately and make the necessary changes.
Another tool that health systems can leverage to deliver effective telehealth is the Health Catalyst Population Builder™: Stratification Module. Population Builder helps health systems manage the care of their patient populations—commonly termed population health—and telehealth allows the care team to lay eyes on a patient, talk to a patient, and interact with a patient. These small encounters can lead to more accurate diagnoses and care, increased patient satisfaction, and better patient-provider relationships.
Population insights can also help health systems in value-based care (VBC) contracts benefit significantly from leveraging telehealth, as VBC incentivizes them to deliver the best care to a patient population within a fixed cost. Health teams can use the Population Builder to stratify patient groups and assign certain groups to telehealth visits based on risk, such as comorbidities, disease severity, age, and socioeconomic factors. For example, a population health team might assign the lowest risk patients to telehealth visits because providers don’t need to see these specific patients in person as often. Or, a population health team might assign the highest risk patients to receive frequent in-person visits with telehealth visits in between to keep the care team up to date. Telehealth solutions allow health teams to increase patient surveillance without the costly burdens (and infection risk during COVID-19) of delivering care in person.
A virtual patient interaction extends the care team beyond the hospital and clinic walls and allows providers to engage with a patient, even if the visit isn’t technically “in-person.” The care team can improve patient care based on these interactions, resulting in better outcomes. Telehealth can also help clinicians follow up on patient responsibilities that have far-reaching effects. For example, a provider could ask a patient about medication compliance and then ask the patient to administer the medication via videoconferencing to ensure that the patient is administering it correctly.
Health systems have used telehealth sparingly for years but have yet to unleash the full spectrum of telehealth benefits. With a sophisticated data platform that can aggregate cost, measure ROI, and provide areas for improvement, health systems can implement data-informed strategies to improve the use of telehealth.
Telehealth is still new for some health systems and takes critical tools to lay its foundation. However, it is an effective way to reach more patients, improve care access, increase patient engagement, and compensate for the inability to deliver non-emergent medical care during a pandemic and beyond.
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