Author: Lea M. Sims
Telehealth is a preschooler with a bright future. Given a launching nudge into the world last year, it has moved beyond its infancy and is ambling forward on new and unsteady feet, eager to explore its possibilities. It has a lot to learn and a great deal of growing to do. There will be missteps, stalls and falls along the way. But in a few years, that tottering walk will become a confident run, and telehealth will become a mature contributor to care delivery.
The "future of telehealth" is a hot topic, and with a newly launched telehealth platform, we're spending a lot of time at Verizon thinking about the trajectory of virtual care and the contingencies that need to be true for it to establish itself as a consistent care delivery model. The COVID pandemic has been a sentinel event in many ways--an epoch in the history of healthcare delivery transformation. There is great need for clinical practice to shift to a hybrid reality, where providers can care for patients in a more agile, real-time manner.
But the success of telehealth in the future is not a foregone conclusion. It's going to require the industry to take some pretty big steps away from traditional models and embrace the imperfect process of iterative transformation.
There's a lot of discussion around what it's going to take for telehealth in the future to deliver on its promise--ecosystem interoperability, expanded (and clarified) reimbursement frameworks, commitments to address digital divide, to name a few. But the industry would be remiss if it focused on technical and logistical challenges alone, without addressing some embedded institutional barriers.
What telehealth needs more than anything else is a chance--an opportunity to prove itself. The greatest barrier to expanded telehealth isn't reimbursement or interoperability. It's systematized practice. "Going to the doctor" has looked the same for decades. Care management has subscribed to an on-site, appointment-driven, episodic care model for so long that it's hard to imagine any other way of doing it. While there are certainly Accountable Care Organizations (ACO) focused on these very questions, most providers are just trying to keep their doors open, manage their patient loads and dig themselves out of a pile of regulatory documentation requirements. Their operational workflows have not changed much. If you ask patients whether they can tell a difference in the way they are cared for today versus ten or twenty years ago, most would say no. The process is the same. The interaction is the same. And the experience of making an appointment, showing up for, and navigating a doctor's "visit" looks pretty much the same today as it did in the past--including the clipboard, wait times, pass offs, and hurried conversations in narrow windows of appointed time with busy providers.
How well is it working?
We already know that traditional allopathic models do little to prevent disease. Value-based care has nudged the industry toward more concerted focus on prevention and management of chronic disease, but the reporting requirements and documentation burden have left little time for clinical practice transformation. For all of the focus on quality measure reporting, we have to ask ourselves: Has the patient-provider relationship truly evolved? Are we more closely connected and accountable to our providers today? Are we better managing chronic conditions?
Despite a lot of regulatory focus and technology innovation, care is still largely transactional, not relational. Telehealth can disrupt this system in really meaningful and potentially game-changing ways. It's more than a convenient, contactless option for clinical conversations. It has the potential to completely transform clinical practice if providers can break away from traditional models and build a brave new world of hybrid care. What would it look like if you had a standing telehealth check-in every month with your care team to talk through your progress, challenges, mental health, wellness, and care needs? What if that consistent virtual meetup was augmented by frequent text messages and other intuitive virtual offerings? What if your provider leveraged telehealth platforms to offer group discussions and roundtables with patients struggling with the same chronic conditions?
Life is now lived in highly virtual, real-time social spaces. Healthcare should adapt to that reality. There are a lot of new horizons. Clinical practice should evolve, and telehealth can help it do that.
The future of telehealth: Telehealth growth indicators
Another thing needed for telehealth growth is time. Children grow in spurts and phases. Development is slow but purposeful. Telehealth will be messy and imperfect in the beginning. The integration of telehealth capabilities into current and emerging models for care will require a commitment from health systems and providers to stick with it until it gets there. Because old habits die hard. There's a very real risk of abandoning telehealth offerings and hybrid practice strategies once the industry emerges from the pandemic if there isn't an appetite to work through the early challenges of patient experience, interoperability, digital divide, and reimbursement.
A recent survey conducted in partnership with HIMSS found that:
- 81% of decision-makers expect their telehealth video conferencing budgets to increase in the next two to three years, moving up by a 36% average.
- 90% of hospital/health system leaders and 80% of clinicians view the ease (and convenience) of telehealth usage as a driver of better patient outcomes.
However:
- 58% of survey takers believe current telehealth technology is too difficult for patients to use, and 80% identified "easy to use" as the number one priority when considering their next telehealth solution.
These are indicators that telehealth will have to learn quickly and perform early. Expectations are high. If it's problematic and disruptive (and it will be), there may very well be a dismissive wave of the hand and a return to business as usual. But where it can be deployed by providers who are eager to see it succeed, there will be a willingness to stick with it through its growing stages. There will be less likelihood of ditching it and returning to traditional practices and more likelihood of telehealth being the launching pad for even greater innovation in virtualized care--where remote patient monitoring, real-time data, omnichannel CX and other capabilities can propel clinical practice to new models that look completely different than care delivery has looked for decades.
That means telehealth will also need champions--providers, decision-makers, tech innovators, patients, associations, legislators, and others--who believe in its potential and are willing to stand behind it until it gets there.
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