Expanding Mindfully into DTC Telehealth

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What to consider before jumping into direct-to-consumer telehealth

By Mike Baird, MBA

The interest in direct-to-consumer (DTC) telehealth is soaring as healthcare organizations seek new ways to improve patient access to medical care.

As noted by a widely publicized Health Affairs report, the healthcare industry performed 1.25 million direct-to-consumer telehealth visits in 2015. That number is projected to rise as stakeholders uncover new uses for virtual care. For example, DTC telehealth can help partners in an Accountable Care Organization (ACO) or patient-centered medical home collaborate better and coordinate care more smoothly. It can help physician practices offer a broader range of services to patients. And it can provide real value to patients.

However, DTC telehealth must be implemented mindfully, with careful consideration of everything from the remote providers servicing patients to the strength of a vendor’s virtual care platform. If a DTC telehealth program is implemented carelessly with no objectives other than to give patients more “face time” with actual doctors healthcare providers run the risk of losing out on telehealth’s most important benefits.



Initial Considerations

In rolling out a DTC telehealth program — or any clinical service, for that matter — an organization must first think carefully about its goals. These can vary, depending on the organization and the type of virtual DTC program(s) an organization wants to offer (e.g., urgent care, SMS messaging consultations, etc.).

A major food-service employer, for example, would need to assess the extent to which DTC telehealth services could enhance workforce benefits and save costs. A small medical provider group, meanwhile, may need to consider whether a particularly flashy virtual platform with lots of built-in features would actually improve patient engagement. And statewide department may need to consider whether DTC telehealth can help overcome a healthcare crisis.

Consider the 2017 flu season, one of the worst in recent memory. Nearly 100 North Texas Schools installed telehealth kiosks to connect students with doctors at Children’s Health in Dallas. These were key in diagnosing dozens of flu cases and speeding up treatment, and may have saved lives.

While the Texas school system may see virtual care differently than a medical practice that is trying to improve access for existing patients, the end result is the same: better, faster, and more comprehensive care that results in better outcomes.

Additionally, an organization needs to assess whether a virtual care platform can generate adequate cost savings. Implementing any new technology requires upfront investment; the return on investment should make the effort worthwhile.

Operational Considerations

In addition to pondering long-term goals, healthcare organizations must also consider the following operational issues when evaluating telehealth platforms:

Interoperability. At a minimum, a telehealth platform must be compatible with a healthcare organization’s EHR. Leveraging telehealth outside of the EHR carries a number of risks, from HIPAA considerations to patient endangerment (say, if a physician makes a discovery during remote consultation, and cannot easily, and immediately, share such information). Whether an organization adopts a system-wide telehealth platform or takes a phased approach, interoperability is the starting point for any discussion of virtual care.

Staffing. One of the biggest decisions healthcare organizations will have to make is on how they’ll staff virtual visits. Many vendors have their own clinical network, which can offer some advantages (e.g., no in-house training burdens) but not all vendor networks are equal. Organizations must ensure vendor partners only utilize high-quality clinicians who are properly vetted. Consumers are wary enough already. As one study noted, patients largely prefer telehealth services with their own physicians. The bottom line: It’s extra important to ensure DTC telehealth physicians and other care providers are up to par with an organization’s high standards.

Visit format. The optimal virtual telehealth service offers patients a high degree of availability, on par with in-person urgent care centers, which are open evenings, weekends and on holidays. Some of the most successful virtual visits mimic house calls: Physicians listen closely and observe carefully, offering a welcome sounding board for the patient. They’re adept at asking questions and determining the appropriate next steps, such as prescribing an antihistamine or, when necessary, sending a patient to the emergency room. What they don’t do is instill doubt in patients, or act like they’d rather get through the virtual encounter so they can return to whatever else they were doing.

These considerations are just the first of many, as organizations evaluate their goals and expectations for DTC telehealth programs. In moving forward, organizations should ensure their DTC telehealth partners have a shared vision of the future.

Mike Baird is the founder and CEO of Avizia, a leading provider of system-wide telehealth.

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