These days, during the COVID-19 health crisis, telehealth is approached by many leaders as a necessary stop gap measure, as something that they have to do, because restricting patients’ access to care altogether is not a viable
option for most healthcare organizations.
Telehealth, on the surface, seems like a fairly easy thing to implement: subscribe to video chat software, equip the clinicians with an iPad or a laptop and start scheduling patients. The main thing that seems to be confusing is billing, but eventually that’ll be sorted out, because it seems like these days you can get reimbursed for virtually anything (pun intended).
But as the COVID-19 health crisis is now entering the fifth week of widespread social distancing, it is becoming evident that good will and a can-do attitude alone cannot sustain a virtual practice.
By now it has occurred to most enlightened leaders, that quite possibly telehealth is here to stay for good; that a portion of care services can indeed be delivered at a distance without a great loss of clinical quality, if any at all.
Few conditions, if any, are diagnosed on the spot by a physician and even fewer are exclusively diagnosed by laying hands on a patient. Most diagnoses require tests (involving biofluids or tissue samples), exams (such as X-rays, sonography or CT scans) or a simple "wait and see" approach. Many vital signs these days can be relatively reliably obtained by the patients themselves.
In my 20 years of experience in healthcare, I have found that the clinicians, nurses and others involved in providing or enabling the delivery of care are incredibly patient (which is kind of funny, because the modern healthcare consumers of today are anything but ‘patient’). They will go to extreme lengths to ensure that patients get the best possible care.
And while this crisis endures, our healthcare professionals are genuinely worried about patients not getting the care they need, they will tolerate a wide array of breakdowns in the processes and technologies.
But as time progresses, what seemed like an acceptable thing to do in the first weeks of this crisis, now is no longer sustainable.
Just last week one provider described to us that in their practice, it’s the providers who are scheduling and rescheduling patients and helping patients with the technology, which, as you can imagine, is "not really working well" for them.
The honeymoon period — for providers, staff, and patients — will be over soon, if it isn’t already.
The Top 4 Side Effects of Poorly Implemented Telehealth
By not doing telehealth right, you are inviting a whole host of potential problems that can hurt your practice in the very near future.
The consequences of poorly implemented telehealth include serious long term ramifications for the sustainability of your outpatient practice. With innovative, nimble players like Medicare Advantage Plans and Medicaid CMOs; with cash-pay virtual-only healthcare providers like Teladoc, Amwell, or Parsley Health; and with employer-paid, virtual-first providers such as Amazon Care and Walmart Health, the competition for virtual care, the fight for your patients’ attention, will become incredibly fierce in 2021. And it’s those easy-to-treat conditions so amenable to telehealth, that provide your
practice with a sustainable business model.
Over the past decade I have implemented dozens of telehealth services and have developed a thoughtful, comprehensive approach that typically took weeks to design and implement, which we are now able to launch in a matter of days. All of the "side effects" below can be easily avoided and mitigated early if you allow an expert to guide the process.
1. Poor Patient Experience and Patient Attrition — while patient satisfaction with telehealth is typically very high, it is largely because patients are mostly grateful for the convenience and the safety that receiving care at home presents. But direct-to-consumer telehealth with bring-your-own-device technology is one of the top 5 most challenging telehealth services. Over the years, we have developed and taught our clients a set of proactive practices that
lead to stellar patient experiences.
Patients now find themselves in a fiercely-competitive landscape that knows no geographic boundaries. Once they have experienced a smooth, professional, awesome telehealth visit vs. one fraught with technical glitches, confusing communication and not-very-confident and not-very-professional-looking physicians (e.g., grainy picture, poor lighting, awkward face framing, distracting background, etc.) — patients, when given the choice, very clearly know which telehealth provider they will want to use in the future. They will take their virtual care needs elsewhere.
2. Poor Financial Performance and Legal Risks — the reimbursement landscape for telehealth shifted dramatically in March 2020 as widespread social distancing took hold and CMS and other agencies opened the floodgates to ensure that care could be delivered to those who needed without the fear of diminishing revenue. But the playing field is not the same across all clinical specialties, provider levels, and definitely not across all payors. During this special
time, it takes a tremendous amount of attention to detail to stay abreast the rapidly changing landscape.
Traditionally, the billing team is at the tail end of a healthcare organization’s money trail and other than the occasional reject claim, the tail would never "wag the dog". But telehealth requires a very different mindset. If not implemented, it will hurt the financial performance of an organization — by rendering non-billable services or by leaving money on the table by not taking advantage of the new ways to provide remote care that is reimbursable).
But the main reason for poor financial performance is that most organizations are failing to bring their visit volumes quickly up to pre-covid volumes. One of our clients was back up at over 80% of visit volume by the 7th day of implementing telehealth. Therein lies the true, measurable cost of poorly performing telehealth services.
