As hospitals look towards the “post-COVID-19” doom, they are shifting their focus to increase operational facilities and immediately create additional cost and workflow opportunities. The old saying “necessity is the mother of invention” holds true now more than ever before.
Patient care decision, dictated by necessary safety measures, has obligated hospital leaders to completely recalibrate how they address healthcare visits, pushing mobile-based solutions such as Telehealth, Home Monitoring, Virtual Waiting Rooms, and Virtual Visits; the list goes on and on.
As telehealth proves to be a cost-effective and safe beam of hope for the patient that would otherwise not receive care, it is also a solution for hospitals to give and deliver care amidst overwhelming public concern due to the COVID-19 pandemic.
Expanding access to care through telehealth seems to be a promising option for hospitals. Despite this benefit, however, there are still several concerns with the efficiency and implementation of a hospital virtual care program or Telehealth.
While there are many advantages to implementing telemedicine, there are some sound concerns as well as several misunderstandings. In this article, we will provide solutions to the top 10 concerns of hospitals considering telehealth maneuvering. The primary goal of this article is to provide resources and solutions to common telehealth challenges.
- Patient comfort, adoption & retention concerns
A common myth among experts is the concern of an impersonal patient experience due to the virtual environment of a telehealth visit. It is often believed that because patients and providers are communicating through a video screen and that visits are smaller than your traditional in-person visit, a virtual visit will lack a feeling of human contact and cause issues with patient satisfaction. This is a myth; patients often have minor feelings of human connection during an in-person visit than during a telehealth visit.
According to studies, during an in-person visit, 64% of primary care physicians did not ask why a patient came in, and when they did, patients were interrupted within 11 seconds. But, virtual visits – especially those used in telemental health – often compel patients and providers to look each other in the eye. As well, the telemedicine platform can improve synergies for patients who aren’t comfortable seeing a doctor in person.
While there is surely a distance barrier and looking at a monitor can feel less human, there are a few practices that will help your patients feel as though they are speaking with a person and not a computer.
- Providers can build rapport with their patients by communicating with them. A simple question, “How are you doing?” can go a long way in building a human connection through a computer. Asking patient-centered subjects about their goals for care at the beginning of the visit can open a healthy discussion between provider and patient. If the patient is fresh to the virtual visit experience, providers can educate them by discussing the aspects of the visit and virtual care.
- Making direct eye contact, actively listening, and not interrupting when the patient is speaking can all enhance the patient experience during a virtual visit. In addition, building a welcoming virtual care environment with quality telehealth-appropriate cameras, natural lighting, and room aesthetics can also improve the patient experience.
- If the patient is less familiar with initiating a telehealth visit, which is a common barrier for elderly individuals, providers should take special care to create an inviting environment and anticipate their needs, especially for individuals who lack proficiency with technology.
By following these practices, you will make a considerable positive influence on patient engagement and the success of your virtual care program.
- Diagnosis & exam difficulties
While telehealth is suitable for a wide collection of care needs-from treating the common cold, flu, UTI, insect bites, sore throats, post-op check-ins, remote monitoring, and more. But, some situations require an in-person examination.
According to a study examining the effectiveness of consumer electronics within a telehealth exam, elements of the physical examination that are easily observed show great concordance, while posterior structures and elements that are difficult to observe using consumer communications technology limit the utility of the telehealth exam.
- Providers should use their best knowledge and follow protocol to determine when and how to schedule an in-person exam. The clear advantage of a hospital- or clinic-implemented telehealth approach is the readiness to schedule an in-person visit when necessary.
- To lessen the impact on patients, providers should also be prepared to schedule the exam during the telehealth visit. Hospital- and clinic-based telehealth programs should develop a protocol for in-person exams, including scheduling, coordination, payment, and a contactless check-in.
- Providers will need to describe the aspects of the exam that will take place, follow-up considerations, and other preparations. For example, if a patient is coming in for a urinalysis to test for UTI, the provider might collect payment and any other information ahead of time to expedite the visit.
- Considering COVID-19 and other Healthcare-associated infections (HAI) exposure risks, clinics should also encourage patients to bring a mask and wait in their vehicles if their room is not available upon arrival.
While translating a telemedicine visit to an in-person examination is not always perfect from a patient perspective, full communication about the scope of care and easing the check-in process will drastically minimize any negative impact.
- Quality of care & linking concerns
The top patient concern regarding telehealth is the low quality of care. There is not enough evidence to suggest that the quality of care given is lower for telehealth other than what may be derived from limitations of care. Given that telehealth improves access to care through lower costs and by meeting patients where they are, virtual care advances health care consequences.
However, lack of data for care continuity has the potential to add risk as patient records may not reflect outcomes, treatment plans, and diagnoses from outside telehealth providers. This lack of platform unification between providers is common.
However, adding telehealth options within hospitals and clinics where patients receive primary care can eliminate this risk through interconnectivity within the Electronic Health Record (EHR). By using a platform that integrates with your EHR, you can record your practiced workflow and ensure your patients’ e-visits are properly documented and updated for future visits.
In cases where this circumstance is unavoidable, the best solution is to request details of your patient’s latest visit and attempt to access their medical records to eliminate misdiagnosis and treatment risks.
- Clinician burnout
One of the top concerns for telehealth is physician burnout due to lack of face-to-face time with patients and increased time updating the patient’s medical records in the EHR. With packed days, high demand, and increasing burdens and complications caused by COVID-19, clinician burnout is certainly a major concern for healthcare systems and physicians. However, the rate of burnout is primarily a result of workflow inefficiencies.
Telemedicine Reduces Provider Burnout, 42% of providers experience clinician burnout leading to poor performance, which can lead to medical errors. Telehealth can create greater versatility and day-to-day variety through telehealth days. Providers can see patients from their office or their home. This allows them to telecommute and save the total travel time. It proves to be a nice break from daily hustles.
- Medicare & Medicaid reimbursement concerns
This is cited as a top challenge for telemedicine programs. The applicability of telehealth has been suppressed for years due to state and central reimbursement restrictions.
Though there has been much improvement in recent years, before the COVID-19 pandemic, federally run Medicare coverage had many limitations on how coverage could be applied. Earlier, for instance, Medicare billing requirements mandated the telehealth visit must take place within a Health Professional Shortage Area (HPSA) and at an authorized originating site, such as a physician’s office, hospital, or skilled nursing facility.
This has completely destroyed any advantage of telehealth as a home option, virtual care visit, and reimbursement was only applicable to specific Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes.
With the onset of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) temporarily expanded Medicare reimbursement and applicable services to expand telemedicine options. This expansion allowed Medicare to pay for visits regardless of location, including within a patient’s home and allows for a wider range of providers to offer virtual visits.
Medicaid has been less limiting. While most states do reimburse for live telehealth, relatively few states cover store-and-forward or remote patient monitoring telehealth. It is a good idea to check your specific state laws and policies.
- Telehealth limitations & regulations
Today, health care providers may, in good faith, provide telehealth services to patients using remote communication technologies, such as commonly used apps – including FaceTime, Facebook Messenger, Google Hangouts, Zoom, or Skype – for telehealth services. Furthermore, the established patient with a physician requirement is no longer required, which means a physician can see a new patient and still receive Medicare reimbursement during this public health emergency.
- Privacy & security concerns
As telehealth is a virtual bidirectional interaction between providers and patients sharing health information, there is an understandable concern regarding potential privacy breaches, particularly for patients. Providers should ensure patient-provider trust by maintaining strict standards in safeguarding patient privacy and security. When communicating electronic Protected Health Information (ePHI), it is critical to use a system to monitor these conversations and prevent breaches.
Providers should seek a compliant communication platform that will have encrypted data transmission and allows only authorized users to access ePHI. It is essential to consider all potential threats to the integrity of ePHI, particularly virtual environment changes or end-user risks.
For example, if a provider or third-party contractor is working from home, connected to a hospital network, it is important to ensure that they are fully protected against potential cyber-attacks.
According to studies, VPNs are one of the most common, secure, and strong methods for connecting remotely to an enterprise network. However, organizations have been failing to patch core vulnerabilities found in some of the most recommended VPNs, despite repeated warnings and available patches.
For patient end protection, consider executing two-factor authentication to add more protection against cyber-attacks and have a detailed plan to address security and privacy concerns and take measures to protect patient security and ease potential apprehension.
- Program awareness Affairs, Sustainability & Growth
Growing efforts and sustainability are both top concerns for any new hospital venture; however, there are some strategic practices to consider before beginning a successful telehealth initiative.
The best methods to establish a virtual care program in an existing hospital includes placement within a specific area of the building, such as near the ER or out-patient check-in, to positively impact the promotion of the virtual care program through physical exposure, shared responsibilities among the providers, care managers, nurses, front desk staff, and schedulers in actively promoting telehealth as an option to current patients.
- Technical Training & Restructuring Obligations
Restructuring and learning new methods and processes in preparation to implement telemedicine within a hospital is a labor-intensive endeavor.
There is a need for the characteristics and roles of a clinical telehealth champion who pushes the implementation and virtual care program forward.
The four distinct core components and roles of each telemedicine team: Core, Leadership, Advisory, and Implementation are also needed. Within Telehealth Staff & Care Team Roles & Responsibilities, there must be five cross-compatible roles among existing clinical staff to structure your new virtual care team. You must know the methods to prepare your team and evaluate your program to ensure a smooth patient experience.
- Hospital Integration & Implementation Concerns
Implementing and integrating a virtual care option within a hospital may seem a daunting process. However, proper structure, planning, and alignment with the organization’s purpose will facilitate implementation within a tighter timeline.
Providers can start by creating a business plan that outlines the scope of the project, helps determine its efficacy, and steers the next steps. It is important to impersonate your business plan to key stakeholders and discuss the elements and challenges ahead to gain buy-in.
The providers must ensure to discuss their service plan assessment, financial plans, marketing, and optimal placement strategy, organizational structure, security, patient satisfaction concerns, and training framework openly to address any potential gaps and gain momentum.
While there are still some limitations on telehealth, many healthcare providers are innovating to solve these issues and improve their patients’ access to quality care. Now that you know some solutions to the concerns of telehealth, you’re ready to start thinking about how your practice will approach this booming healthcare trend.