This level is so important (and a good resting place before advancing to the next three levels) because it forms the foundation for a more advanced utilization of telehealth beyond the augmentation of inpatient and outpatient services. The level of “Supported” is the base from which an organization can expand into reaching the “Integrated” level, which is a significant mindshift from the historical view of telehealth.

At the supported level, the senior leadership of the organization fully embraces and values telehealth as a clinical care delivery tool and provides the necessary resources to provide sufficient operational and technical support. In addition, at this level a designated, skilled team is charged with assisting various clinical departments with the launch of new telehealth services through project management, clinical workflow design, technology selection and training.

So where do most organizations start in telehealth? Most organizations, especially during the early months of the Covid-19 health crisis, started out at the “Chaotic” level. Each department, each service line (and even in some cases each physician) was permitted to launch telehealth in the way they thought was right or at least acceptable. Before Covid-19, enthusiastic staff, often clinicians, would secure access to telehealth technology, often with little to no coordination with IT or involvement of Finance and no coordination with other departments.

The “Chaotic” level can be good as it can create quick success due to the dedication of a clinical champion “to make it work” which can serve as positive inspiration to the rest of the organization. But the danger of launching telehealth with little to no strategic thought and no centralized, experienced support is that many services will fall short of their possibilities, because a single person, especially a clinician, can only do so much.

Now that the Covid-19 health crisis has pointed a bright spotlight onto telehealth, there is much more awareness from senior leadership, yet oftentimes no true support. The result are dismally performing telehealth service with many disillusioned clinicians that leave patient’s puzzled as to why their experience was so bad compared to their or their friends’ and family’s experience with other providers.

At the next level, “Emerging”, leadership becomes aware of the strategic need for telehealth yet still does not set a central resource aside to aid in the launch and in the sustaining operation of existing and new telehealth services.

At this level of maturity, the adoption of telehealth services is accelerating and one of the first to notice (and put some coordination behind it) is the IT department, because ultimately things eventually break. While it was okay to get SaaS licenses online, working on the actual integration and configuration does require IT expertise.

At organizations with an “Emerging” maturity level, leadership awareness and endorsement (though not support) is present, IT is much more involved and some attention is paid to the financial performance of the services.

The last step toward the final destination is “Coordinated”. Here, the different telehealth services across the organization are coordinating their efforts. At times an unofficial person, sometimes from billing, sometimes from IT and sometimes from informatics, emerges as the knowledgeable resource, though the position is not appropriately funded. Success is still based on the heroic efforts of a few individuals.