Why Telehealth Is Not About Technology

“Every system is perfectly designed

to get the results it gets.”

-- Donald M. Berwick, MD, MPP

Quick! Let’s play a word association game: What are the first five words that come to mind when you hear the word “telehealth”? [cue Jeopardy music here]

How about video, distance, network, telephone, camera? What images come to mind? That notorious stethoscope neatly draped around a computer monitor? Blinking lights and electrodes attached to a bedridden patient?

Yet, Telehealth -- delivering care at a distance -- is not about technology. Because when telehealth is just about the technology it fails, every time. Telehealth is about engaging with patients at a distance. It’s not about the carts, not about the robots, or any other gadgetry that allows the continuous monitoring of any vital sign or movement.

First and foremost, Telehealth is about people - the patients, the caregivers, the providers, the care team, the schedulers, the coders. If people don’t like it, they won’t use it. If people don’t understand why they should use it, they won’t use it as effectively.

Secondly, to make sure that telehealth is about the people, telehealth is about processes to deliver telehealth effectively and efficiently. “Every system is perfectly designed to get the results it gets.” is a quote often attributed to Don Berwick, the founder of the Institute of Healthcare Improvement, which I use for inspiration and guidance on every project. Purposefully designed telehealth processes make sure that people can use the technology to achieve the results they want: easier, more frequent access, more efficient and cost-effective care, and ultimately better coutcomes

This includes the processes for scheduling virtual appointments, effectively handling ad hoc visits, having defined contingency plans to deal with life’s (and technology’s) inevitable mishaps, providing the tools and means to coordinate and synchronize workflows at the two different locations (the patient’s and the provider’s location), plus all the administrative processes (e.g., billing), and the operational and technical support processes (e.g., training and help desk).

When it comes to a successful telehealth program, technology comes in dead last.

Now, granted, that hasn’t always been the case. Getting the technology right, the networks correctly configured, getting different video standards to talk to each other or ensuring a great picture and great sound hasn’t always been a relatively trivial task. “Back in the days”, a lot of thought had to be given to ensure that the technology did not stand in the way and that it was as user friendly as possible.

Nowadays, however, most of the technology for telehealth is off-the-shelf or available from reputable telehealth vendors that have been around long enough to have worked out all the kinks. Therefore, technology takes a back seat when it comes to the implementation of successful telehealth services.

Organizations that are very successful with telehealth, also have made telehealth an integral part of their overall strategic plan. These clinics, urgent care centers, and integrated health systems have developed a clear long-term vision how telehealth in all of its facets will help them to provide the best care to their patients.

These organizations also leverage telehealth as an opportunity to redesign key healthcare delivery processes such as scheduling and pre-appointment communication. The introduction of telehealth provides an opportunity to map current workflows and to identify inefficiencies that can be removed by a redesign of the process.Those that utilize telehealth as an avenue for exploring new methods and processes for service delivery, clearly have a leg-up on their competition.

The most successful healthcare organizations have also realized that telehealth is a strategic effort driven by the clinical practice and not an IT initiative or the heroic effort of just one specialty. For those organizations it’s not an “IT job” or even a job for the Director of Outreach. It’s a job for the CMO, the CMIO, the COO or the CFO.

Because Telehealth is not about the technology. It’s about purposefully designed processes that enable care teams to provide excellent care at a distance that delights patients and staff alike.

When will you design your telehealth system to get the results you want to get?

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Christian Milaster is the Founder and CEO of Ingenium Digital Health where he and his expert advisors partner with healthcare leaders to optimize the delivery of care. Contact Christian by phone or text at 657-464-3648, via email, or video chat.